A Lost Opportunity to Reduce Future Risk Among Justice-Involved Young Adults Through HIV Testing and Counseling

HIV rates among young adults remain high, and those impacted by the justice system are at particular risk. Understanding the factors associated with HIV testing, as well as determining changes in risk behavior after an HIV test, may inform interventions to reduce HIV prevalence among this population. As such, this study sought to determine the individual, contextual, and demographic factors associated with HIV testing among legal-system-impacted young adults and to explore whether a first HIV test is associated with changes in future risk behavior when compared to Never Tested individuals. Significant predictors of HIV testing included the absence of a biological father (OR = 0.68, <i>p</i> = 0.049), a higher variety of lifetime offending (OR = 4.74, <i>p</i> = 0.015), and living in Philadelphia vs. Phoenix (OR = 3.07, <i>p</i> < 0.001). Compared to those never tested for HIV, those newly tested significantly increased in their number of unprotected sexual partners (<i>b</i> = 0.52, <i>p</i> < 0.001) and in the number of times they had unprotected sex (<i>b</i> = 0.47, <i>p</i> < 0.001) one year later. This study is one of the first to assess predictors of HIV testing among legal-system-impacted young adults living across both community and carceral settings and to assess changes in risk behavior before and after a first HIV test. Future studies should investigate changes in risk behavior among those newly tested to inform HIV testing and care improvement interventions for this population.