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Polyvictimization and depression as predictors of HIV risk behaviors among juvenile offenders

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Understand the relationship between polyvictimization and engagement in HIV risk behaviors. Examine the potential mediating role of depression for this relationship.


This study utilized data from the Pathways to Desistance study. This study comprised the responses of 1354 juvenile offenders across the 84 months following adjudication for a serious offense. A series of Poisson regression models was utilized to conduct analyses.


Results indicate that participants reporting greater levels of direct polyvictimization engaged in a greater variety of HIV risk behaviors during the following observation period. This effect was not observed for witnessed polyvictimization. Adding depression to the model resulted in full mediation of this effect.


Direct polyvictimization was found to be a predictor of HIV risk behaviors, with depression mediating. This indicates the importance of strong screening for trauma histories to determine the presence of polyvictimization in the criminal justice system at intake and reentry.

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  1. 1.

    The 6th through 11th waves were the only waves at which HIV risk behavior data were assessed. The fifth wave was chosen because the effects of exposure to violence variables on HIV risk behaviors are lagged one observation period to establish temporal ordering of effects. Baseline data included in analyses consisted of demographic characteristics.

  2. 2.

    The HIV risk behaviors included in the count variable were: having unprotected sex, injecting drugs, having sex with a partner who injected drugs, sharing a needle with another person, and trading sex for drugs/money/other.

  3. 3.

    The direct polyvictimization items contributing to the count were: Have you been chased where you thought you might be seriously hurt? Have you been beaten up, mugged, or seriously threatened by another person? Have you been raped, had someone attempt to rape you, or been sexually attacked in some other way? Have you been attacked with a weapon, like a knife, box cutter, or bat? Have you been shot at? Have you been shot? The witnessed polyvictimization items are analogous to this but in the context of seeing the event happen, rather than being the victim, with the addition of one final item: have you seen someone else get killed as a result of violence, like being shot, stabbed, or beaten to death?

  4. 4.

    The individual deviant peer association items included: How many of your friends have suggested that you should go out drinking with them? How many of your friends have suggested or claimed that you have to get drunk to have a good time? How many of your friends have suggested or claimed that you have to be high on drugs to have a good time? How many of your friends have suggested that you should sell drugs? How many of your friends have suggested that you should steal something? How many of your friends have suggested that you should hit or beat someone up? How many of your friends have suggested that you should carry a weapon?

  5. 5.

    It should be noted that the actual magnitude of the reduction in the effect between the models was relatively modest (~10%).


  1. Agnew R (1992) Foundation for a general strain theory of crime and delinquency. Criminology 30:47–88

  2. American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders: DSM-5. American Psychiatric Association, Washington, D.C

  3. Andrews AR, Jobe-Shields L, López CM, Metzger IW, de Arellano MA, Saunders B, Kilpatrick DG (2015) Polyvictimization, income, and ethnic differences in trauma-related mental health during adolescence. Soc Psychiatry Psychiatr Epidemiol 50:1223–1234

  4. Bath H (2008) The three pillars of trauma-informed care. Reclaiming children and youth 17:17–21

  5. Bhatti AB, Usman M, Kandi V (2016) Current scenario of HIV/AIDS, treatment options, and major challenges with compliance to antiretroviral therapy. Cureus 8(3)

  6. Boroughs MS, Valentine SE, Ironson GH, Shipherd JC, Safren SA, Taylor SW, Dale SK, Baker JS, Wilner JG, O’Cleirigh C (2015) Complexity of childhood sexual abuse: predictors of current post-traumatic stress disorder, mood disorders, substance use, and sexual risk behavior among adult men who have sex with men. Arch Sex Behav 44:1891–1902

  7. Brame R, Fagan J, Piquero AR, Schubert CA, Steinberg L (2004) Criminal careers of serious delinquents in two cities. Youth Violence Juvenile Justice 2:256–272

  8. Burns CR, Armour C (2018) Lifetime interpersonal Polyvictimization: abuse typologies and mental health outcomes in a nationally representative sample of men from the United States. Inter J Pop Data Sci 3(2)

  9. Caravaca-Sánchez F, Wolff N (2018) Understanding polyvictimization in prison: prevalence and predictors among men inmates in Spain. J Interpers Violence 0886260518775751

  10. Carlson CE, Witte SS, Pala AN, Tsai LC, Wainberg M, Aira T (2017) The impact of violence, perceived stigma, and other work-related stressors on depressive symptoms among women engaged in sex work. Global social welfare 4:51–57

  11. Center for Disease Control (2011) HIV surveillance—United States, 1981–2008. Morb Mortal Wkly Rep 60:689–693

  12. Chen Y, Yao S, Zhu X, Jinyao YI (2017) Efficacy of cognitive behavioral therapy for middle school student's unprotected sex: a randomized controlled trial. Chin Ment Health J 31(1):1–6

  13. Clements-Nolle K, Larson S, Buttar A, Dermid-Gray L (2017) Childhood maltreatment and unprotected sex among female juvenile offenders: evidence of mediation by substance abuse and psychological distress. Womens Health Issues 27:188–195

  14. Cooper H, Friedman SR, Tempalski B, Friedman R, Keem M (2005) Racial/ethnic disparities in injection drug use in large US metropolitan areas. Ann Epidemiol 15:326–334

  15. Degenhardt L, Peacock A, Colledge S, Leung J, Grebely J, Vickerman P, Stone J, Cunningham EB, Trickey A, Dumchev K, Lynskey M, Griffiths P, Mattick RP, Hickman M, Larney S (2017) Global prevalence of injecting drug use and sociodemographic characteristics and prevalence of HIV, HBV, and HCV in people who inject drugs: a multistage systematic review. Lancet Glob Health 5:e1192–e1207

  16. Delaney AX, Wells M (2017) Polyvictimization experiences and depression among youth living in foster care. Crim Justice Rev 42:146–162

  17. de Oliveira RD, Daly M, Seidl-de-Moura ML, Nadanovsky P (2017) The role of city income inequality, sex ratio and youth mortality rates in the effect of violent victimization on health-risk behaviors in Brazilian adolescents. Soc Sci Med 181:17–23

  18. Dong M, Anda RF, Felitti VJ, Dube SR, Williamson DF, Thompson TJ, Loo CM, Giles WH (2004) The interrelatedness of multiple forms of childhood abuse, neglect, and household dysfunction. Child Abuse Negl 28:771–784

  19. Finkelhor D, Ormrod RK, Turner HA, Hamby SL (2005) Measuring poly-victimization using the juvenile victimization questionnaire. Child Abuse Negl 29:1297–1312

  20. Finkelhor D, Turner H, Hamby SL, Ormrod R (2011) Polyvictimization: Children's exposure to multiple types of violence, crime, and abuse. OJJDP Juvenile Justice Bulletin NCJ235504:1-12

  21. Flexon JL, Meldrum RC, Young JT, Lehmann PS (2016) Low self-control and the dark triad: disentangling the predictive power of personality traits on young adult substance use, offending and victimization. J Crim Just 46:159–169

  22. Ford JD, Elhai JD, Connor DF, Frueh BC (2010) Poly-victimization and risk of posttraumatic, depressive, and substance use disorders and involvement in delinquency in a national sample of adolescents. J Adolesc Health 46:545–552

  23. Ghosh AK, Osswald HL, Prato G (2016) Recent progress in the development of HIV-1 protease inhibitors for the treatment of HIV/AIDS. J Med Chem 59:5172–5208

  24. Ho YF, Ng MH, Tsai CC, Lee CH, Tsai D, Chou JY, Shao WC, Lin TY, Chen VCH, Gossopi M (2017) Major depression and related factors among heroin users who received methadone maintenance treatment in Taiwan: a case control study. J Subst Use 22:457–462

  25. Hollingshead, A.B. (1957). Two Factor Index of Social Position. Mimeo. New Haven, Connecticut: Yale University

  26. Hollingshead AB (1971) Commentary on the indiscriminate state of social class measurement. Soc Forces 49:563–567

  27. Janowicz DM (2016) HIV transmission and injection drug use: lessons from the Indiana outbreak. Top Antivir Med 24(2):90

  28. Johnsen TJ, Friborg O (2015) The effects of cognitive behavioral therapy as an anti-depressive treatment is falling: a meta-analysis. Psychol Bull 141:747

  29. Kerr T, Stoltz JA, Marshall BD, Lai C, Strathdee SA, Wood E (2009) Childhood trauma and injection drug use among high-risk youth. J Adolesc Health 45:300–302

  30. Kinniburgh KJ, Blaustein M, Spinazzola J, van der Kolk BA (2017) Attachment, self-regulation, and competency: a comprehensive intervention framework for children with complex trauma. Psychiatr Ann 35:424–430

  31. Kipke MD, Unger JB, Palmer RF, Edgington R (1996) Drug use, needle sharing, and HIV risk among injection drug-using street youth. Subst Use Misuse 31:1167–1187

  32. Mackesy-Amiti ME, Donenberg GR, Ouellet LJ (2012) Prevalence of psychiatric disorders among young injection drug users. Drug Alcohol Depend 124:70–78

  33. Martin JI, Knox J (1997) Loneliness and sexual risk behavior in gay men. Psychol Rep 81:815–825

  34. McHugh RK, Votaw VR, Sugarman DE, Greenfield SF (2018) Sex and gender differences in substance use disorders. Clin Psychol Rev 66:12–23

  35. Moffitt TE (1993) Adolescence-limited and life-course-persistent antisocial behavior: a developmental taxonomy. Psychol Rev 100:674–701

  36. Moret JED, Carrico AW, Evans JL, Stein ES, Couture MC, Maher L, Page K (2016) The impact of violence on sex risk and drug use behaviors among women engaged in sex work in Phnom Penh, Cambodia. Drug Alcohol Depend 161:171–177

  37. Morris RE, Baker CJ, Valentine M, Pennisi AJ (1998) Variations in HIV risk behaviors of incarcerated juveniles during a four-year period: 1989–1992. J Adolesc Health 23:39–48

  38. Pasa MK, Alom KR, Bashri Z, Vermund SH (2016) Sharing of needles and syringes among men who inject drugs: HIV risk in Northwest Bangladesh. PLoS One 11:e0148276

  39. Quinn K, Boone L, Scheidell JD, Mateu-Gelabert P, McGorray SP, Beharie N, Cottler LB, Khan MR (2016) The relationships of childhood trauma and adulthood prescription pain reliever misuse and injection drug use. Drug Alcohol Depend 169:190–198

  40. Schroeder JR, Epstein DH, Umbricht A, Preston KL (2006) Changes in HIV risk behaviors among patients receiving combined pharmacological and behavioral interventions for heroin and cocaine dependence. Addict Behav 31:868–879

  41. Segura A, Pereda N, Guilera G, Abad J (2016) Poly-victimization and psychopathology among Spanish adolescents in residential care. Child Abuse Negl 55:40–51

  42. Senbanjo R, Wolff KIM, Marshall EJ, Strang J (2009) Persistence of heroin use despite methadone treatment: poor coping self-efficacy predicts continued heroin use. Drug Alcohol Rev 28:608–615

  43. Shernoff M (2006) Condomless sex: gay men, barebacking, and harm reduction. Soc Work 51:106–113

  44. Steinberg LD, Cauffman E, Monahan K (2015) Psychosocial maturity and desistance from crime in a sample of serious juvenile offenders. US Department of Justice, Office of Justice Programs, Office of Juvenile Justice and Delinquency Prevention, Laurel, MD

  45. Thorlindsson T, Bernburg JG (2006) Peer groups and substance use: examining the direct and interactive effect of leisure activity. Adolescence 41(162)

  46. Tobin K, Davey-Rothwell MA, Nonyane BA, Knowlton A, Wissow L, Latkin CA (2017) RCT of an integrated CBT-HIV intervention on depressive symptoms and HIV risk. PLoS One 12:e0187180

  47. Tohme J, Egan JE, Stall R, Wagner G, Mokhbat J (2016) HIV prevalence and demographic determinants of unprotected anal sex and HIV testing among male refugees who have sex with men in Beirut, Lebanon. AIDS and Behavior, 20(3):408–416

  48. Ulibarri MD, Strathdee SA, Ulloa EC, Lozada R, Fraga MA, Magis-Rodríguez C, De La Torre A, Hortensia A, O’Campo P, Patterson TL (2011) Injection drug use as a mediator between client-perpetrated abuse and HIV status among female sex workers in two Mexico-US border cities. AIDS Behav 15:179–185

  49. Voisin DR, Chen P, Fullilove R, Jacobson KC (2015) Community violence exposure and sexual behaviors in a nationally representative sample of young adults: the effects of race/ethnicity and gender. J Soc Serv Res 41:295–306

  50. Willie T, Kershaw TS (2018) Associations between latent classes of interpersonal polyvictimization and polyperpetration and sexual risk behaviors among young pregnant couples: a dyadic analysis. Arch Sex Behav 47:1699–1709

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Correspondence to Thomas Wojciechowski.

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Wojciechowski, T. Polyvictimization and depression as predictors of HIV risk behaviors among juvenile offenders. J Public Health (Berl.) (2020). https://doi.org/10.1007/s10389-020-01221-2

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  • HIV risk behaviors
  • Juvenile offenders
  • Polyvictimization
  • Depression