DOCUMENT RESUME ED 325 776 CG 022 932 AUTHOR Woodruff, John O., Ed.; And Others TITLE Troubled Adolescents and HIV Infection. INSTITUTION Georgetown Univ. Child Development Center, Washington, DC. CASSP Technical Assistance Center. SPONS AGENCY Health Resources and Services Administration (DHHS/PHS), Rockville, MD. Bureau of Maternal and Child Health and Resources Development.; National Inst. of Mental Health (DHHS), Rockville, MD. Child and Adolescent service System Program. PUB DATE Oct 89 NOTE 152p. AVAILABLE FROMCASSP Technical Assistance Center, Georgetown University Child Development Center, 3800 Reservoir Rd., NW, CG-52 Bles, Pediatrics, Washington, DC 20007. PUB TYPE Books (010) -- Collected Works - General (020) EDRS PRICE MF01/PC07 Plus Postage. DESCRIPTORS *Acquired Immune Deficiency Syndrome; *Adolescents; At Risk Persons; Delinquency; Drug Abuse; Foster Care; Mental Disorders; Research; *Youth Problems ABSTRACT This report on adolescents, Acquired Immune Deficiency Syndrome (AIDS), and Human Immune Virus (HIV) infection had its beginning in the Knowledge Development Workshop "Issues in the Prevention and Treatment of AIDS Among Adolescents with Serious Emotional Disturbance," held June 9-10, 1988 in the District of Columbia. These papers are included: (1) "Emotionally Disturbed Adolescents and AIDS: An Introduction" (Jean Garrison Athey); (2) "AIDS Among Adolescent Subgroups: Inferences from Research and Theory on Delinquency and Sexuality" (Peggy C. Giordano and H. Theodore Groat);(3) "Barriers to Successful AIDS Prevention Programs with Runaway Youth" (Mary Jane Rotheram-Borus, Cheryl Koopman, and Jon Bradley); (4) "Issues in AIDS Prevention Among Juvenile Offenders" (Jon Rolf, Joy Nanda, Linda Thompson, Joyce Mamon, Anjani Chandra, Julie Baldwin, and Michael Delahunt);(5) "Prevalence of HIV-Related High-Risk Sexual and Drug-Related Behaviors Among Psychiatrically Hospitalized Adolescents: Preliminary Results" (Ralph J. DiClemente, Lynn Ponton, Diana Hartlfay, and Susan McKenna); (6) "High-Risk Youth Who Use Health Clinics: A Profile of a Population Accessible for AIDS-Related Interventions" (Arlene Stiffman and Felton Earls); (7) "AIDS and the Sexually Abused Adolescent" (Ann W. Burges and Carol R. Hartman); and (8) "Adolescents with AIDS in Foster Care: A Case Report" (Robert Jones, Bonnie Jud)uns, and Gary Timbers). A list of the speakers at the Knowledge Development Workshop is included. (ABL) Reproductions supplied by EDRS are the best that can be made from the original document. TROUBLED ADOLESCEINTS AIND 1-11V INFECTION "PERMISSION TO REPRODUCE THIS U.S. DEPARTMENT OF EDUCATION Office of Ectucahom Research and Improvement MATERIAL HAS SEEN GRANTED SY EDUCATIONAL RESOURCES INFORMATION CENTER (ERIC) GC lei til 4-5 0 4` pqn.e document has been reproduced as wimp's from the person or organizatior onginahng C Minor changes hare been made to Improve reproduction duality Pornts0tn.worcptrrionSstRtedintflhSd0CU TO THE EDUCATIONAL RESOURCES mint co not NICIIISerdy riOreSentofficial INFORMATION CENTER (ERIC).- OERI position or ooscy mak CASSP Technical Assistance Center Georgetown University Child Development Center TR8dBLEn An8LE5CEINT5 ANn HIV INFECT18N 11/ Issues In Prevention and Treatment Co-Edited by John 0. 'Noodruff Diane Doherty and Jean Garrison Athey October, 1989 This report is funded by the National Institute of Mental Health, Child and Adolescent Service System Program (CASSP) Available from: CASSP Technical Assistance Center Georgetown University Child Development Center 3800 Reservoir Rd., NW OG-52 Bles, Pediatrics Washington, DC 20007 (202) 687-8635 .) an Health, Services. Resource oftheGeorgetownthroughandAdolescent ofMentalandandHuman isfunded Child Health Center the Institute ChildHealth /'t 4, Center of National and Assistance between Maternal Department Development Program,of Technical agreement U.S. Child SystemBureau CASSP the The UniversityinteragencyServiceand Development, CONTENTS Preface iii Smotionally Disturbed Adolescents and AIDS: An Introduction 1 Jean Garrison Athey, Ph.D. CHAPTER 1: AIDS Among Adolescent Subgroups:Inferences from Research and Theory on Delinquency and Sexuality 14 Peggy C. Giordano, Ph.D., and H. Theodore Groat, PhD. CHAPTER 2: Barriers to Successful AIDS Prevention Programs with Runaway Youth 37 Mary Jane Rotheram-Borus, Ph.D., Cheryl Koopman, Ph.D., and Jon S. Bradley, M.S.W. CHAPTER 3: Issues in AIDS Prevention Among Juvenile Offenders 56 Jon Rolf, Ph.D., Joy Nanda, B.A., Linda Thompson, Ph.D., Joyce Mamon, Ph.D., Anjani Chandra, B.S., Julie Baldwin, B.S., and Michael Delahunt, M.H.S. 5 i i CHAPTER 4: Prevalence of HIV-Related High-Risk Sexual and Drug-Related Behaviors Among Psychiatrically Hospitalized Adolescents: Preliminary Results....70 Ralph J. DiClemente, Ph.D., Lynn E. Ponton, M.D., Diana Hartley, Ph.D., and Susan McKenna, M.R.T. CHAPTER 5: High-Risk Youths Who Use Health Clinics: A Profile of a Population Accessible for AIDS-RelatedInterventions 89 Arlene Stiffman, Ph.D., and Felton Earls, M.D. CHAPTER 6: AIDS and the Sexually Abused Adolescent 107 Ann W. Burgess, R.N., D.N.Sc., and Carol R. Hartman, R.N., D.N.Sc. CHAPTER 7: Adolescents with AIDS in Foster Care: A CaseReport 122 Robert Jones, Ph.D., Bonnie Judkins, M.A., and Gary Timbers, Ph.D. List of Speakers at Knowledge Development Workshop, "Issues in the Prevention and Treatment of AIDS Among Adolescents with Serious Emotional Disturbance" 140 6 Ill PREFACE NI Georgetown University is pleased to have been ableto collaborate with the National Institute of Mental Health in the preparationand publication of this monograph. This projectwas made possible through an interagency agreement between the Child and Adolescent Service SystemProgram, National Institute of Mental Health, and the Division ofMaternal and Child Health, U.S. Department of Health andHuman Services, and the Georgetown University Child Development Center. In recent years, concern about the spread ofHIV infection among adolescents has grown, particularlyas a result of the increased awareness that many of the young adults with AIDSwere likely infected as adolescents. Concern about the spread of HIVamong adolescents has invigorated examination of the issues relevantto HIV infection and adolescents and has brought many of those workingwith adolescents to a new understanding of the complexity of those issues. This monograph had its beginningat the Knowledge Development Workshop, "Issues in the Prevention andTreatment of AIDS Among Adolescents With Serious Emotional Disturbance,"held June 9 and 10, 1988 in Washington, DC, and sponsored by theChildren and Youth At Risk Project of the Georgetown University ChildDevelopment Center and the Child and Family Support Branch of theNational Institute of Mental Health. The meeting brought togethera diverse group of experts working with troubled adolescents ina variety of settings and under a wide range of circumstances and provided them with the opportunityto share the data, information and experience they had developed withrespect to adolescents and HIV infection. 7 - iv The purpose of this monograph is to initiate further discussion and examination of some specific issues associated with HIV infection and troubled, or emotionally disturbed, young people in order to facilitate the prevention and treatment of HIV infection among adolescents. Unfortunately, it is impossible to comprehensively cover all or even many of the issues relevant to HIV infection and troubled adolescents in a single volume. The Child Development Center views this monograph as a beginning--a springboard--for further research, discu,ion, and action designed to assist those who work with troubled adolescents in the process of developing effective prevention, education and treatment programs and strategies that will limit the spread of the HIV epidemic. tz On behalf of the Child Development Center and NIMH, I would like to thank all of the conference participants whose concern and dedication made this document possible. Jean Garrison Athey of NIMH and Diane Doherty and John Woodruff of Georgetown University deserve special mention for the expertise and attention they brought to the process of substantive editing and topic selection. I would also like to thank Jane Myers of Janus Associates and Kathleen McGhee of Georgetown for their meticulous and expert editing of the text and references. Finally, mognition and thanks go to the support staff at the Child Development Center that made the meeting a success, and specifically to Gail Ellison and Kathleen McGhee who patiently compiled and proofread the manuscript. Phyllis Magrab, Ph.D. Director Georgetown University Child Development Center October, 1989 J 1 EMOTIONALLY DISTURBED ADOLESCENTS AND AIDS: AN INTRODUCTION Jean Garrison Athey, Ph.D. This monograph examines issues associated with emotionally disturbed adolescents and their risk of infection with the human immunodeficiency virus (HIV) that causes AIDS. "Emotionally disturbed," however, is not well-defined, nor does it describe a specific condition. The Child and Adolescent Service System Program (CASSP) of the National Institute of Mental Health defines the term somewhat flexibly to include level of functioning (specifically, the ability to perform in the family, in school, or in the community), need for services from two or more agencies (such as mental health, substance abuse, health, education, juvenile justice, or social services), and a diagnosable problem. Since diagnoses of childhood mental disorders typically