Incarceration and Risky Sexual Partnerships in a Southern US City

Abstract

Incarceration is strongly associated with HIV infection and may contribute to viral transmission by disrupting stable partnerships and promoting high-risk partnerships. We investigated incarceration and STI/HIV-related partnerships among a community-based sample recruited for a sexual behavior interview while frequenting venues where people meet sexual partners in a North Carolina city (N = 373). Men reporting incarceration in the past 12 months were more likely than men without recent incarceration to experience multiple new sexual partnerships (unadjusted prevalence ratio [PR] 1.8, 95% confidence interval [CI]: 1.1-3.1) and transactional sex defined as trading sex for money, goods, or services (unadjusted PR: 4.0, 95% CI: 2.3-7.1) in the past 4 weeks. Likewise, women who were ever incarcerated were more likely than never-incarcerated women to experience recent multiple new partnerships (unadjusted PR: 3.1, 95% CI: 1.8-5.4) and transactional sex (unadjusted PR: 5.3, 95% CI: 2.6-10.9). Sexual partnership in the past 12 months with someone who had ever been incarcerated versus with partners with no known incarceration history was associated with recent multiple new partnerships (men: unadjusted PR 2.0, 95% CI 1.4-2.9, women: unadjusted PR 4.8, 95% CI 2.3-10.1) and transactional sex (men: unadjusted PR 3.3, 95% CI 1.7-6.6, women: unadjusted PR 6.1, 95% CI 2.4-15.4). Adjustment for demographic and socioeconomic variables had minimal effect on estimates. However, the strong overlap between incarceration, partner incarceration, and substance abuse had substantial effects in multivariable models. Correctional-facility and community-based HIV prevention, with substance abuse treatment, should reach currently and formerly incarcerated individuals and their sexual partners.

Incarceration and High-Risk Sex Partnerships among Men in the United States

“…Our findings support the hypothesis that incarceration may contribute to sexual risk behavior both among illicit drug users, a high-risk sample, and nonusers of illicit drugs, the majority population. These results support existing evidence of an association between incarceration and sexual risk behavior among both high-risk 22,23,25 and general population samples 21,24 and highlight the need for STI/HIV prevention and treatment among former and current prisoners regardless of drug use history. Among men who had not used illicit drugs in the past 12 months, the majority of the sample, recent incarceration was strongly associated with multiple and concurrent partnerships and unprotected sex independent of sociodemographic factors, age at first sex, and frequent binge drinking or marijuana use in the past 12 months.…”

“…Our prior research in North Carolina has suggested that social venues where those with a history of incarceration are likely to socialize and meet sex partners are promising sites for community-based STI/HIV education, testing, and condom promotion. 25 In addition, drug treatment centers constitute existing community-based infrastructures that could be used to reach the formerly incarcerated and other vulnerable populations in need of both drug treatment and STI/HIV prevention and treatment.…”

“…9,[15][16][17][18][19] Partnership concurrency is considered to be a particularly important determinant of STI/HIV transmission. 20 There is evidence that incarceration history is associated with high-risk sex partnerships including multiple and concurrent partnerships; 15,17,[21][22][23][24][25] however, most studies have been performed in small convenience samples. Given incarceration has become an important social force that likely influences STI/HIV epidemiology, 9,26,27 a large, nationally representative study of this association is needed to best understand the potential population-level effects of incarceration on relationships and health.…”

Prevalence of sexually transmitted infections based on syndromic approach and associated factors among Iranian women

“…Another finding of the current study was the association between a history of incarceration for women's spouse (or sexual partner) and the likelihood of syndromic STIs. This result is in line with previous studies which had shown that incarceration can increase the likelihood of engaging in high-risk sexual behaviors, such as having multiple sexual partners; thus incarceration can be associated with an increased risk of getting STIs (38,39). The background studies had also shown that women who had a history of incarceration were more likely to have multiple sexual partners (27).…”

Examining the Temporal Relationship Between Criminal Justice Involvement and Sexual Risk Behaviors among Drug-Involved Men

“…In this study, several risk behaviors found to be associated with criminal justice involvement in previous cross-sectional research, such as multiple partnerships, 7,45,46 were not found to be temporally associated with arrest or incarceration. The findings of this paper do not necessarily contradict these studies; rather, they suggest that previously found associations may be spurious and are likely influenced by social and structural factors which impact upon both criminal justice involvement and sexual risk.…”