, Volume 85, Issue 1, pp 100-113
Date: 20 Nov 2007

Incarceration and Risky Sexual Partnerships in a Southern US City

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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.

Khan, Weir, Adimora, Kaufman, and Miller are with the Department of Epidemiology, School of Public Health, University of North Carolina, Chapel Hill, NC, USA; Wohl is with the Center for AIDS Research, University of North Carolina, Chapel Hill, NC, USA; Wohl, Adimora, and Miller are with the Division of Infectious Diseases, School of Medicine, University of North Carolina, Chapel Hill, NC, USA; Weir is with the The MEASURE Evaluation Project, Carolina Population Center, University of North Carolina, Chapel Hill, NC, USA; Moseley is with the Guilford County Department of Public Health, Greensboro, NC, USA; Norcott is with the Sickle Cell Disease Association of the Piedmont, Guilford County, NC, USA; Duncan is with the Triad Health Project, Guilford County, NC, USA.