Women Inmates' Risky Sex and Drug Behaviors: Are They Related?

Abstract

The large concentration of female illicit drug users in state correctional facilities prompted an examination of the associations among different types of drug use and sexual risk factors related to human immunodeficiency virus (HIV) among women inmates. A consecutive sample of 805 women felons admitted to the North Carolina Correctional Institution for Women between July 1991 and November 1992 was interviewed. Of these inmates, 651 had complete information on relevant characteristics. Of the women inmates, 73% had used drugs prior to incarceration; most women were crack smokers only (33%), followed by non-drug users (27%), other drug users (19%), crack-smoking injecting drug users (15%), and injecting drug users only (6%). Inconsistent condom use with multiple sex partners, a history of a diagnosed sexually transmitted disease (STD), a drug-injecting sex partner, or exchanging sex for money or drugs prior to incarceration were reported by 55% of the women. Sexual risk factors differed across different types of drug users, with crack-smoking injectors being placed at greatest potential risk for exposure to heterosexually transmitted HIV, followed by injecting drug users, crack smokers, and then other drug users. Given the differential associations between sexual risk factors and types of drug use, prison-based sexual-risk reduction strategies should be tailored to specific types of drug users. In times of limited resources, special attention should be given to crack smokers and/or drug injectors.

Risky sexual behavior among women with protective orders against violent male partners

“…This finding is consistent with many studies in the literature that have found that alcohol abuse and illicit drug abuse are independently associated with high risk sexual behavior, and the risk for HIV transmission [45,54]. Substance abusing individuals may engage in higher risk sexual behavior because of impaired decisionmaking while under the influence of substances [10], as well as be more likely to have higher risk sexual partners [6,29].…”

Pre‐incarceration HIV risk behaviours of male and female inmates

“…Rates of unprotected vaginal sex with multiple partners reported by men and women in our study (49.6 and 40.3%, respectively), was lower than the 62% reported for participants in a similar study conducted in four prisons in the State of Illinois, USA (Swartz et al, 2004). The rate of unprotected vaginal intercourse found among men in our study is similar to that obtained among men in three States in the USA (49.6 vs. 45.3%; Seal et al, 2008) and the rate among women is similar to that reported in a previous study (40.3 vs. 35%) (Cotten-Oldenburg et al, 1999). A quarter of the women and 14% of the men in our study reported IDU.…”

“…A quarter of the women and 14% of the men in our study reported IDU. Compared with some other studies, IDU was low in our study (Cotten-Oldenburg et al, 1999;Belenko, Shedlin, & Chaple, 2005). In our study, male and female participants who reported inconsistent condom use with multiple anal sex partners were more likely to report the same with multiple vaginal sex partners.…”

Intravenous Drug Users' HIV‐Risk Behaviors with Primary/Other Partners

“…Numerous studies have found that condom use is more likely with IDUs' nonsteady partners than with primary or steady partners (1,5,6,(8)(9)(10)(11)(12)(13). Additional sexual risk behaviors practiced by IDUs involve exchanging sex for drugs or money, engaging in sexual intercourse with other IDUs, and using alcohol and/or drugs prior to or during sex (8,(11)(12)(13)(14)(15)(16).…”

“…Some have assessed drug users' HIV risk behaviors in inpatient treatment, primary care clinics, methadone maintenance programs, and while incarcerated (9,12,15,19). The current study was undertaken to identify differences between IDUs (in a needleexchange program) who report no sexual behavior, those who report sex with one partner, and those who report sex with more than one partner in the past six months.…”