A national overview of reproductive health care services for girls in juvenile justice residential facilities.

UNLABELLED: PURPOSE/RESEARCH QUESTIONS: Adolescent girls involved in the juvenile justice system face a substantially higher risk for a host of reproductive health problems. This study is the first national overview of the extent to which Juvenile Justice Residential Facilities (JJRFs) are meeting their reproductive health needs. The primary focus is whether all girls/young women receive gynecologic services.
METHODS: Data are from the 2004 Juvenile Residential Facility Census, an ongoing national institution-level data collection. Respondents include facility administrators and facility health care providers. Mixed-gender and girls-only facilities are included in these analyses (n = 1,255). MAIN
FINDINGS: Full population testing for pregnancy and sexually transmitted diseases occurs in <18% of all facilities. Although about 25% of all JJRFs report housing > or =1 pregnant teens, an equal number offers no obstetric services. Most JJRFs (about 85%) report that only some girls receive care from a gynecologist, largely "as necessary" and based on self-reports of sexual activity or suspected pregnancy. Provision of gynecologic services to all girls/young women is significantly more likely in all-female, state-owned, large population, and longer stay facilities and less likely in short stay, mixed-gender, crowded, and locally and privately owned facilities.
CONCLUSIONS: Results indicate that most facilities can garner a few necessary services. However, contrary to recommendations of national organizations, the services tend to be provided in an ad hoc manner rather than to the full population of young women. Results of multivariate models predicting facility types most likely to provide full population services should be useful as leaders in the area retarget their recommendations to address this gap in services.