Sexual Health Intervention for Adolescent Girls in Substance Abuse Treatment: Trauma, Sexuality, and Substance Using Behaviors

Abstract

Adolescent girls with substance use disorders (SUDs) are not receiving the help they need. Studies have found high rates of co-occurring mental health disorders, trauma histories, and increased risk of unintended pregnancy and sexually transmitted infections among girls with SUDs. However, few receive substance abuse treatment and many do not receive sexuality education. Integrating sexuality education into substance abuse treatment is a logical, promising, yet uncommon, approach to improve overall outcomes for youth with SUDs. The purpose of this study was to evaluate an integrated approach to sexual health intervention and substance abuse treatment and related outcomes on girls' substance-using and sexual risk-taking behaviors. Further, this study explored whether participants’ trauma histories and/or sexual attitudes impacted response to the intervention. Sixty-seven girls participated in this single sample, longitudinal study. Paired sample t-tests were conducted to measure change over time in high-risk drinking, illicit drug use, sexual health-related knowledge, and unprotected sex. Regression analyses were conducted to investigate whether reported symptoms indicative of trauma history, as well as sexual attitudes, impacted participants' response to the intervention. The majority of girls maintained low or decreased their drinking risk and their unprotected sex risk over time, and increased sexual health-related knowledge. Participants with higher baseline anxiety symptoms were more likely to avoid high-risk drinking post-treatment. Participants' sexual esteem at intake was related to their illicit drug use after treatment. While there are practical barriers to integrating sexual health interventions and substance abuse treatment, the results suggest there are effective strategies for successful integration of much-needed services.