The association between depressive symptoms, substance use, and HIV risk among youth with an arrest history

Objective: Juvenile justice youth are at increased risk for contracting human immunodeficiency virus (HIV)/sexually transmitted infections because of higher rates of substance use and sexual risk-taking behaviors. However, little is known about the relationship between depressive symptoms, substance use, and HIV risk among youth who traditionally present with behavioral symptoms. Method: Adolescents and young adults (N = 835) who participated in a larger multisite HIV prevention program in three states provided baseline data on depressive symptoms, substance use, sexual risk, risk attitudes, and mental health history. Participants were grouped as arrestees and nonarrestees based on self-reported arrest history. This study examined differences between juvenile arrestees with depressive symptoms (n = 27) and those without depressive symptoms (n = 181) on various substance-use, sexual-risk, and mental health outcomes. Results: Arrestees who endorsed a clinically significant level of depressive symptoms reported significantly greater drug and alcohol use, greater substance use during sex, a lower proportion of condom use, and more psychiatric hospitalizations than arrestees without depressive symptoms. Conclusions: Greater depressive symptomatology among juvenile arrestees is associated with increased risk for substance use and HIV; however, these findings need to be replicated with a larger, more representative sample of juveniles with depressive symptoms. Understanding more about the association of depressive symptoms with drug behaviors and sexual risk among juvenile offenders, even at time of first arrest, is essential for creating successful substance use and HIV prevention interventions within the juvenile justice system.