Adolescents exposed to trauma experience disproportionate rates of HIV/STI. However, integrated treatment for trauma and sexual risk behavior is rare. To inform integrated prevention efforts, the current study describes prevalence and correlates of sexual risk behavior among adolescents seeking treatment for symptoms of posttraumatic stress and substance use disorders. Adolescents aged 13–18 years (N = 135; 88% female) with histories of interpersonal violence exposure completed pre-treatment questionnaires in a randomized controlled trial of an integrated psychotherapy for trauma and substance use symptomology. Adolescents reported high rates of sexual risk behaviors relative to national estimates and general mental health treatment samples. Symptoms of reexperiencing, substance use, and peer deviance were related to sexual risk behavior beyond the influence of other trauma symptoms. Individual and contextual psychosocial factors may be stronger predictors of sexual risk behavior than posttraumatic stress disorder symptoms among adolescents with trauma symptomology. Integrated interventions targeting traumatic stress, substance use, and sexual risk behavior concurrently may prevent revictimization and HIV/STI incidence among trauma-exposed youth.

遭受创伤的青少年感染 HIV/STI 的比例高得离谱。然而，针对创伤和性危险行为的综合治疗很少见。为了为综合预防工作提供信息，当前的研究描述了寻求治疗创伤后应激障碍和物质使用障碍症状的青少年中危险性行为的流行率和相关性。具有人际暴力暴露史的 13-18 岁青少年（N = 135；88% 为女性）在针对创伤和物质使用症状的综合心理治疗的随机对照试验中完成了治疗前问卷。相对于国家估计和一般心理健康治疗样本，青少年报告的性危险行为发生率很高。再体验的症状，物质使用，和同伴偏差与性危险行为相关，超出了其他创伤症状的影响。在有创伤症状的青少年中，个体和背景心理社会因素可能比创伤后应激障碍症状更能预测性危险行为。同时针对创伤性应激、物质使用和危险性行为的综合干预措施可以防止遭受创伤的青年再次受害和 HIV/STI 发病率。