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Substance use (SU), criminal justice involvement (CJI), and HIV/AIDS co-occur in many urban families, but little is known about their intergenerational prevalence and the impact of their conjunction on these families. We determined lifetime prevalence of SU, CJI, and HIV/AIDS in 62 families with a member (the index case) on parole or probation for a drug offense and enrolled in the direct service arm of Family Justice, La Bodega de La Familia--a community support program in New York City's Lower East Side. Among these families, index cases are 94% male, and 97% Latino, with a median age of 37. Records of 80% of open cases, in months March through May, in 2003 (N = 62) were reviewed, and the family maps or "genograms," were analyzed and coded (by age, sex, and relationship to the index) to identify all significant members with histories of SU, CJI, and HIV/AIDS. Of the 62 families (with a total of 592 individuals) 82% had at least one other member besides the index case with a history of SU, 62% had two or more, and 40% had three or more; 72% had one other member with a history of CJI, 45% had two or more, and 24% had three or more. At least one member had HIV/AIDS in 49% of the families, 16% had two or more, and 10% had three or more. Of the 105 family members who reported a history of CJI, 88% had a history of substance use. These data demonstrate the extent to which many families in communities such as this are struggling with the burdens associated with having multiple relatives involved in the criminal justice system, largely related to drug use and frequently with HIV and AIDS. These data point to an important role for family-focused interventions to ameliorate the consequences of high rates of familial drug use, incarceration and other forms of CJI, and HIV/AIDS.

The Concentration of Substance Use, Criminal Justice Involvement, and HIV/AIDS in the Families of Drug Offenders