Neighborhoods, Caregiver Sexuality Communication, and Sexual Health of Adolescents Involved in the Legal System.
Rusley J, Tolou-Shams M, et al. • Journal of correctional health care : the official journal of the National Commission on Correctional Health Care • 2025
Higher sexual behavior score (representing higher STI risk) among adolescents newly involved in the juvenile legal system was independently associated with lower-quality sexuality communication with caregivers and less neighborhood cohesion.
Key Findings
Results
Higher sexual behavior score was independently associated with lower-quality sexuality communication with caregivers among adolescents involved in the juvenile legal system.
Study used data from 423 adolescent-caregiver dyads newly involved with the juvenile legal system.
Multinomial models were used to determine associations between higher sexual behavior score and multilevel factors.
Sexual behavior score was designed to represent higher sexually transmitted infection (STI) risk.
The association between caregiver sexuality communication quality and sexual behavior score was independent of other factors examined.
Results
Higher sexual behavior score was independently associated with less neighborhood cohesion among adolescents newly involved in the juvenile legal system.
Neighborhood cohesion was identified as a multilevel factor within an ecodevelopmental resilience framework.
The association between neighborhood cohesion and sexual behavior score was independent of other factors examined.
The study examined neighborhood-level factors alongside caregiver-level factors as part of a multilevel ecological analysis.
Lower neighborhood cohesion was framed as a risk factor for higher-risk sexual behavior in this population.
Background
Adolescents in the juvenile legal system were identified as having unaddressed sexual health needs requiring multilevel intervention.
The study used an ecodevelopmental resilience framework to guide analysis of multilevel risk and protective factors.
Factors examined spanned multiple ecological levels including caregivers and neighborhoods.
The sample consisted of 423 adolescent-caregiver dyads newly involved with the juvenile legal system.
The study aimed to identify targets for future intervention by determining associations between sexual behaviors and multilevel factors.
Conclusions
Improving caregiver sexuality communication quality and prioritizing sexual health resources in lower-cohesion neighborhoods were identified as promising intervention targets.
Both caregiver-level (sexuality communication quality) and neighborhood-level (cohesion) factors were identified as modifiable intervention targets.
The focus was specifically on adolescents newly involved in the juvenile legal system, suggesting early intervention potential.
These targets were identified based on their independent associations with higher sexual behavior scores in multinomial models.
The authors framed these as 'promising intervention targets to improve sexual health' for this population.
What This Means
This research examined what factors are linked to higher-risk sexual behaviors among teenagers who are newly involved in the juvenile justice system. The researchers studied 423 pairs of adolescents and their caregivers, looking at influences from multiple levels of these young people's lives, including their relationships with caregivers and the neighborhoods where they live. They found that two factors were independently associated with higher-risk sexual behavior: having lower-quality conversations about sex and sexuality with caregivers, and living in neighborhoods with less social cohesion (meaning residents feel less connected and trusting of one another).
This research suggests that teenagers in the juvenile legal system — a group known to have significant unmet sexual health needs — may benefit from interventions that work on more than one level simultaneously. Helping caregivers have better quality conversations about sex with their teenagers, and directing sexual health resources toward neighborhoods where community ties are weaker, could be effective strategies for reducing sexually transmitted infection risk in this vulnerable population.
The findings are notable because they highlight that neighborhood-level factors, not just individual or family factors, play a role in adolescent sexual health outcomes. This research suggests that addressing sexual health disparities among justice-involved youth may require community-level approaches alongside family-focused interventions, rather than focusing solely on individual behavior change.
Rusley J, Tolou-Shams M, Li Y, Dauria E, Marshall B, Wohl A, et al.. (2025). Neighborhoods, Caregiver Sexuality Communication, and Sexual Health of Adolescents Involved in the Legal System.. Journal of correctional health care : the official journal of the National Commission on Correctional Health Care. https://doi.org/10.1089/jchc.24.05.0040