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Section 2. Recommendations for Care of Children in Special Circumstances
HEPATITIS AND YOUTH IN CORRECTIONS SETTINGS 1
The number of arrests of juveniles younger than 18 years of age in the United States has stabilized at 2.5 million per year but continues to represent nearly 5% of the pediatric population. More than 300 000 youth are maintained annually in detention facilities awaiting court hearings, and on any given day, 126 000 adolescents are incarcerated in juvenile corrections facilities or adult jails. Incarceration periods of at least 90 days await 60% of juvenile inmates, and 15% can expect to spend a year or more behind bars. Incarcerated youth disproportionately are male and are more likely to be members of ethnic or racial minorities. Female juveniles constitute 15% of the incarcerated juvenile population, and pregnancy often presents additional challenges in the provision of medical services in corrections facilities.
Juvenile offenders commonly lack regular access to preventive health care in their communities and suffer significantly greater health deficiencies, including psychosocial disorders, chronic illness, exposure to illicit drugs, and physical trauma when compared with adolescents who avoid the juvenile justice system.
1 Detained youth are more likely to have contracted sexually transmitted diseases (STDs) early in adolescence, and delayed or incomplete treatment places them at increased risk of chronic complications of chlamydia, gonorrhea, syphilis, and human papillomavirus infections. Tuberculosis (TB) is more common in corrections populations, and although the current population of juvenile detainees continues to have a low prevalence of human immunodeficiency virus (HIV) infection, their lifestyle choices place them at significant risk.
2 Hepatitis A, B, and C infections, however, are of particular concern because of the increased frequency of alcohol and injection drug use and increased rate of unprotected sex with multiple partners earlier in life. Juvenile
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