Incarcerated women report multiple vulnerabilities and, yet, are under-represented in research. This study used focus-group methodology to explore high-risk sexual behaviors, drug use, and victimization among female offenders in St. Louis. Inmates of the St. Louis Medium Security Institution (MSI) were invited to participate in one of five focus groups between May and September 2005 in preparation for an NIH/NINR HIV-prevention intervention study among female offenders in Drug Court. The focus group sample of 30 women was 70% African-American, with a mean age of 36 years. Results indicated that oral sex was the most common sex trade activity. Consistent with the literature, condom usage was described as irregular. In terms of drug use, participants reported that crack was most commonly used, with binges often lasting for several days. Regarding victimization, women frequently reported sexual abuse in childhood, and some described abusive relationships as adults. Participants also reported being beaten and raped by customers, which led to their concealing knives in purses and razors under the tongue. Consequently, perpetrated violence, including murder, was reported as protection against further violence. These findings confirm the vulnerability of this population of women who are at high risk for HIV. Effective HIV-prevention interventions are needed to assist these incarcerated women in making lifestyle changes during incarceration and sustaining them after release.

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