Neighborhoods, Caregiver Sexuality Communication, and Sexual Health of Adolescents Involved in the Legal System.

Adolescents in the juvenile legal system have unaddressed sexual health needs. Factors at multiple ecological levels-including caregivers or neighborhoods-may promote or hinder sexual health for this group. We aimed to identify targets for future intervention by determining the associations between sexual behaviors and multilevel risk and protective factors among adolescents involved in the juvenile legal system. To do this, we examined data from adolescent-caregiver dyads newly involved with the juvenile legal system and used an ecodevelopmental resilience framework and multinomial models to determine associations between higher sexual behavior score (representing higher sexually transmitted infection risk) and multilevel factors. Among 423 dyads, higher sexual behavior score was independently associated with lower-quality sexuality communication with caregivers and less neighborhood cohesion. Improving the quality of caregiver sexuality communication and prioritizing sexual health resources in neighborhoods with lower cohesion are promising intervention targets to improve sexual health for adolescents newly involved in the juvenile legal system.