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Abstract
Juvenile offenders bear a disproportionate burden of sexually transmitted infections (STIs) such that rates are 8 to 10 times higher than their non-offending peers. A number of factors impact the sexual health of juvenile offenders at the individual, interpersonal, organizational, and policy level. However, minimal research has addressed the organizational and policy level factors impacting the sexual health of juvenile offenders. The purpose of this study was to explore the policies and procedures that impact the sexual health infrastructure for juvenile offenders. The three specific aims of the study were to (a) identify how sexual health needs are determined; (b) identify the current sexual health programs and services provided; and (c) identify the barriers and facilitators impacting the sexual health infrastructure for juvenile offenders. This qualitative study used semi-structured interviews (N=6) to collect data from service providers who work directly with juvenile offenders in varying professional roles. Grounded theory methodology was used to analyze interview data and develop an emergent theoretical framework resulting from the individual, interpersonal, community, organizational, and policy level barriers and facilitators mentioned by service providers. Service providers reported conducting assessments, exploring trends in data, and conversing with juvenile offenders to assess their sexual health needs. However, service providers mentioned their lack of knowledge and training as significant barriers impacting juvenile offenders access to and use of sexual health services. Nine policy recommendations resulted in response to the barriers mentioned by service providers and were presented according to their level of implementation within a socio-ecological framework. At the individual level, consent education and probation officer inclusion along with educating parents/guardians at the interpersonal level were recognized as policy recommendations. Community collaboration is a community level policy recommendation. At the organizational level, providing a sexual health education exit program for juvenile offenders and sexual health training for service providers were identified as policy recommendations. Policy level recommendations included mandating evidence-based sexual health education and providing sexual health education as part of probation requirements. Future research should incorporate quantitative methodology into understanding how the sexual health of juvenile offenders can be addressed from an organizational and policy perspective.