Justice-involved youth have a number of risk factors for HIV infection, including high rates of substance use, psychiatric comorbidities, and risky sexual behaviors. Although detained youth are likely to receive health care-which may include HIV testing-court-involved, non-incarcerated (CINI) youth may be unlikely to receive HIV testing services either before or during their justice involvement. However, the relationship between risk factors and HIV testing among CINI youth is largely unknown. We explored the association between HIV testing and factors commonly associated with both HIV testing and HIV risk among 173 CINI youth with identified behaviors that put them at risk for HIV acquisition. Only 15.6% of participants reported a lifetime history of HIV testing, despite high rates of sexual and substance use risk behaviors. Age (older), gender (female), sexual orientation (non-heterosexual), recent marijuana use, lifetime use of other drugs, history of a sexually transmitted infection, pap smear in the past year and history of mental health/substance use treatment were all significantly associated with lifetime HIV testing. The extremely low testing rates in this sample emphasize that the juvenile justice system outside of detention is not adequately addressing youths needs related to HIV testing or ensuring access to testing services for youth at risk of contracting HIV. Results suggest that additional efforts are needed to connect justice-involved youth to healthcare more broadly and HIV testing in particular.

Youth involved in the justice system meet criteria for psychiatric disorders at much higher rates than youth in the general population and a large body of research has established a relationship between mental health problems and delinquency or recidivism. However, only limited research has examined the relationship between specific types of psychopathology and specific patterns or types of delinquency for justice-involved youth and only a single study has explored the relationship between psychopathology and delinquency among youth with psychiatric diagnoses receiving mental health treatment. We examined the relationship between severity of offending and internalizing and externalizing symptoms among court-involved, non-incarcerated youth referred for mental health treatment. Over half of youth and over two-thirds of parents reported youth symptomatology at the 93rd percentile or above for internalizing symptoms, externalizing symptoms, or both. We found that youth engaged in serious or violent delinquency are more likely to have externalizing problems but that internalizing symptoms were equally high across youth committing minor, moderate, and serious delinquent acts. Findings from this study support the need for future research exploring the nuances of relationships between psychiatric disorder and patterns of delinquency, which can provide helpful information to justice system stakeholders in identifying youth needs.