AIDS and Behavior

, Volume 9, Issue 3, pp 311–323 | Cite as

Sexual and Physical Victimization as Predictors of HIV Risk Among Felony Drug Offenders

  • Steven Belenko
  • Jeffrey Lin
  • Lisa O’Connor
  • Hung-En Sung
  • Kevin G. Lynch
Interpersonal Violence and Aids

Injection and other drug use and high-risk sexual behaviors put criminal offenders at increased risk for HIV infection. Studies in other populations, especially females, have found that a history of sexual or physical victimization increases engagement in HIV-risk behaviors, and drug-involved offenders have high rates of such prior victimization. However, there has been little research among male offenders. In a sample of 247 male felony drug offenders in New York City, prior sexual victimization was related to a higher number of sex partners and lower proportion of protected sex acts in the 30 days before arrest. Prior physical abuse was related to cocaine injection, but not heroin injection or high-risk sex behaviors. These results suggest a complex relationship between sexual and physical abuse and HIV risk among male offenders. Assessing for specific prior abuse histories of offenders and providing targeted interventions may be useful for developing more effective primary and secondary HIV prevention services for this high-risk population.


Physical and sexual abuse drug offenders criminal justice population HIV-risk behaviors. 


  1. Allers, C. T., and Benjack, K. J. (1991). Connections between childhood abuse and HIV infection. Journal of Counseling and Development, 70(2), 309–313. Google Scholar
  2. Altice, F. L., Mostashari, F., Selwyn, P. A., Checko, P. J., Singh, R., Tanguay, S., and Blanchette, E. A. (1998). Predictors of HIV infection among newly sentenced male prisoners. Journal of Acquired Immune Deficiency and Human Retrovirology, 18, 444–453.Google Scholar
  3. Bartholow, B. N., Doll, L. S., Joy, D., Douglas, J. M., Jr., Bolan, G., Harrison, J. S., Moss, P. M., and McKirnan, D. (1994). Emotional, behavioral and HIV risks associated with sexual abuse among adult homosexual and bisexual men. Child Abuse and Neglect, 18(9), 747–761.CrossRefPubMedGoogle Scholar
  4. Bauserman, R. L., Ward, M. A., Eldred, L., and Swetz, A. (2001). Increasing voluntary HIV testing by offering oral tests in incarcerated populations. American Journal of Public Health, 91(8), 1226–1229.PubMedGoogle Scholar
  5. Belenko, S. (2000). The challenges of integrating drug treatment into the criminal justice process. Albany Law Review, 63(3), 833–876.Google Scholar
  6. Belenko, S., and Peugh, J. (1999). Behind bars: Substance abuse and America's prison population (Technical Report). NY: The National Center on Addiction and Substance Abuse at Columbia University.Google Scholar
  7. Belenko, S., and Peugh, J. (2005). Estimating drug treatment needs among state prison inmates. Drug and Alcohol Dependence, 77, 269–281.CrossRefPubMedGoogle Scholar
  8. Belenko, S., Langley, S., Crimmins, S., and Chaple, M. (2004). HIV risk behaviors, knowledge, and prevention among offenders under community supervision: A hidden risk group. AIDS Education and Prevention, 16, 367–385.CrossRefPubMedGoogle Scholar
  9. Braithwaite, R. L., and Arriola, K. R. J. (2003). Male prisoners and HIV prevention: A call for action ignored. American Journal of Public Health, 93(5), 759–763.PubMedGoogle Scholar
  10. Brown, L. K., Kessel, S. M., Lourie, K. J., Ford, H. H., and Lipsitt, L. P. (1997). Influence of sexual abuse on HIV-related attitudes and behaviors in adolescent psychiatric inpatients. Journal of the American Academy of Child and Adolescent Psychiatry, 36(3), 316–322.CrossRefPubMedGoogle Scholar
  11. Brown, L. K., Lourie, K. J., Zlotnick, C., and Cohn, J. (2000). Impact of sexual abuse on the HIV-risk-related behavior of adolescents in intensive psychiatric treatment. American Journal of Psychiatry, 157(9), 1413–1415.CrossRefPubMedGoogle Scholar
  12. Carballo-Dieguez, A., and Dolezal, C. (1995). Association between history of childhood sexual abuse and adult HIV-risk sexual behavior in Puerto Rican men who have sex with men. Child Abuse and Neglect, 19(5), 595–605.CrossRefPubMedGoogle Scholar
  13. Cleary, P. D., Van Devanter, N., Rogers, T., Singer, E., Shipton-Levy, R., Steilen, M., Stuart, A., Avorn, J., and Pindyck, J. (1991). Behavior changes after notification of HIV infections. American Journal of Public Health, 81, 1586–1590.PubMedGoogle Scholar
  14. Cohen, M., Deamant, C., Barkan, S., Richardson, J., Young, M., Holman, S., Anastos, K., Cohen, J., and Melnick, S. (2000). Domestic violence and childhood sexual abuse in HIV-infected women and women at risk for HIV. American Journal of Public Health, 90(4), 560–565.PubMedCrossRefGoogle Scholar
  15. Coyle, S. (1993). The NIDA HIV counseling and education intervention model: Intervention manual (NIIH Publication No. 93-3508). Rockville, MD: National Institute on Drug Abuse.Google Scholar
  16. Dailey, R. M., and Claus, R. E. (2001). The relationship between interviewer characteristics and physical and sexual abuse disclosures among substance users: A multilevel analysis. Journal of Drug Issues, 31(4), 867–888.Google Scholar
  17. Dill, D. L., Chu, J. A., Grob, M. C., and Eisen, S. V. (1991). The reliability of abuse history reports: A comparison of two inquiry formats. Comprehensive Psychiatry, 32, 166–169.CrossRefPubMedGoogle Scholar
  18. Dilorio, C., Hartwell, T., and Hansen, N. (2002). Childhood sexual abuse and risk behaviors among men at high risk for HIV infection. American Journal of Public Health, 92(2), 214–219.PubMedGoogle Scholar
  19. El-Bassel, N., Ivanoff, A., Schilling, R. F., Borne, D., and Gilbert, L. (1997). Skills building and social support enhancement to reduce HIV risk among women in jail. Criminal Justice and Behavior, 24, 205–223.CrossRefGoogle Scholar
  20. El-Bassel, N., Witte, S. S., Wada, T., Gilbert, L., and Wallace, J. (2001). Correlates of partner violence among female street-based sex workers: Substance abuse, history of childhood abuse, and HIV risks. AIDS Patient Care and STDs, 15(1), 41–51.CrossRefPubMedGoogle Scholar
  21. Elze, D. E., Auslander, W., McMillen, C., Edmond, T., and Thompson, R. (2001). Untangling the impact of sexual abuse on HIV risk behaviors among youths in foster care. AIDS Education and Prevention, 13(4), 377–389.CrossRefPubMedGoogle Scholar
  22. Estébanez, M. V., Zunzunegui, M. V., Aguilar, M. D., Russell, N., Cifuentes, I., and Hankins, C. (2002). The role of prisons in the HIV epidemic among female injecting drug users. AIDS Care, 14(1), 95–104.PubMedCrossRefGoogle Scholar
  23. Frank, L. (1999). Prisons and public health: Emerging issues in HIV treatment adherence. Journal of the Association of Nurses in AIDS Care, 10(6), 24–32.PubMedCrossRefGoogle Scholar
  24. Friedman, S. R., Curtis, R., Neaigus, A., Jose, B., and Des Jarlais, D. C. (1999). Social networks, drug injectors’ lives, and HIV/AIDS. New York: Kluwer Academic Publishers.Google Scholar
  25. Fry, R. P., Rozewicz, L. M., and Crisp, A. H. (1996). Interviewing for sexual abuse: Reliability and effect of interviewer gender. Child Abuse and Neglect, 20, 725–729.CrossRefPubMedGoogle Scholar
  26. Goodman, L. A., and Fallot, R. D. (1998). HIV risk-behavior in poor urban women with serious mental disorders: Association with childhood physical and sexual abuse. American Journal of Orthopsychiatry, 68(1), 73–83.PubMedCrossRefGoogle Scholar
  27. Grella, C. E., Annon, J. J., and Anglin, M. D. (2000). Drug use and risk for HIV among women arrestees in California. AIDS and Behavior, 4(3), 289–295.CrossRefGoogle Scholar
  28. Halpern-Felsher, B. L., Millstein, S. G., and Ellen, J. M. (1996). Relationship of alcohol use and risky sexual behavior: A review and analysis. Journal of Adolescent Health, 19, 331–336.CrossRefPubMedGoogle Scholar
  29. Hammett, T. M., Gaiter, J. L., and Crawford, C. (1998). Reaching seriously at-risk populations: Health interventions in criminal justice settings. Health Education and Behavior, 25(1), 99–120.PubMedCrossRefGoogle Scholar
  30. Hammett, T. M., Harmon, P., and Maruschak, L. M. (1999). 1996–1997 update: HIV/AIDS, STDs and TB in correctional facilities (Publication No. NCJ-176344). Washington, DC: U.S. Department of Justice, Office of Justice Programs, National Institute of Justice.Google Scholar
  31. Harlow, C. W. (1999). Prior abuse reported by inmates and probationers (Publication No. NCJ-172879). Washington, DC: U.S. Department of Justice, Office of Justice Programs, Bureau of Justice Statistics.Google Scholar
  32. He, H., McCoy, H. V., Stevens, S. J., and Stark, M. J. (1998). Violence and HIV sexual risk behaviors among female sex partners of male drug users. Women and Health, 27(1), 161–175.CrossRefGoogle Scholar
  33. Hein, K., Dell, R., Futterman, D., Rotheram-Borus, M. J., and Shaffer, N. (1995). Comparison of HIV+ and HIV− adolescents: Risk factors and psychosocial determinants. Pediatrics, 95(1), 96–104.PubMedGoogle Scholar
  34. Hosmer, D., and Lemeshow, S. (1989). Applied logistic regression. New York: Wiley.Google Scholar
  35. Ickovics, J., Morrill, A., Beren, S., Walsh, U., and Rodin, R. (1994). Limited effects of HIV counseling and testing for women: A prospective study of behavioral and psychological consequences. Journal of the American Medical Association, 260, 935–938.Google Scholar
  36. Inciardi, J. A. (1996). HIV risk reduction and service delivery strategies in criminal justice settings. Journal of Substance Abuse Treatment, 13, 421–438.CrossRefPubMedGoogle Scholar
  37. Johnsen, L. W., and Harlow, L. L. (1996). Childhood sexual abuse linked with adult substance use, victimization, and AIDS-risk. AIDS Education and Prevention, 8(1), 44–57.PubMedGoogle Scholar
  38. Johnson, T. P., Aschkenasy, J. R., Herbers, M. R., and Gillenwater, S. A. (1996). Self-reported risk factors for AIDS among homeless youth. AIDS Education and Prevention, 8(4), 308–322.PubMedGoogle Scholar
  39. Kalichman, S. C. (1995). Understanding AIDS: A guide for mental health professionals. Washington, DC: American Psychological Association.Google Scholar
  40. Kalichman, S. C., Greenberg, J., and Abel, G. G. (1997). HIV-seropositive men who engage in high-risk sexual behaviour: Psychological characteristics and implications for prevention. AIDS Care, 9(4), 441–450.CrossRefPubMedGoogle Scholar
  41. Kalichman, S. C., Benotsch, E., Rompa, D., and Gore-Felton, C. (2001). Unwanted sexual experiences and sexual risks in gay and bisexual men: Associations among revictimization, substance use, and psychiatric symptoms. Journal of Sex Research, 38(1), 1–9.CrossRefGoogle Scholar
  42. Knight, K., Holcom, M., and Simpson, D. D. (1994). TCU psychosocial functioning and motivational scales: Manual on psychometric properties. Fort Worth, TX: Texas Christian University, Institute of Behavioral Research.Google Scholar
  43. Landis, S., Earp, J., and Koch, G. (1992). Impact of HIV testing and counseling on subsequent sexual behavior. AIDS Education and Prevention, 4, 61–70.Google Scholar
  44. Lang, M., and Belenko, S. (2000). Predicting retention in a residential drug treatment alternative to prison program. Journal of Substance Abuse Treatment, 19, 145–160.CrossRefPubMedGoogle Scholar
  45. Lang, M., and Belenko, S. (2001). A cluster analysis of HIV risk among felony drug offenders. Criminal Justice and Behavior, 28(1), 24–61.CrossRefGoogle Scholar
  46. Lenderking, W. R., Wold, C., Mayer, K. H., Goldstein, R., Losina, E., and Seage, G. R., III. (1997). Childhood sexual abuse among homosexual men: Prevalence and association with unsafe sex. Journal of General Internal Medicine, 12(4), 250–253.CrossRefPubMedGoogle Scholar
  47. Longshore, D., Anglin, M. D., Hsieh, S., and Annon, K. (1993). Sexual behaviors and cocaine preference among injection drug users in Los Angeles. Journal of Drug Issues, 23(3), 363–374.Google Scholar
  48. Mahon, N. (1996). New York inmates’ HIV risk behaviors: The implications for prevention policy and programs. American Journal of Public Health, 86(9), 1211–1215.PubMedGoogle Scholar
  49. Martin, S. S., O'Connell, D. J., Inciardi, J. A., et al. (2003). HIV/AIDS among probationers: An assessment of risk and results from a brief intervention. Journal of Psychoactive Drugs, 35, 435–43.PubMedGoogle Scholar
  50. Maruschak, L. M. (2002). HIV in Prisons 2000 (Publication No. NCJ-196023). Washington, DC: U.S. Department of Justice, Office of Justice Programs, Bureau of Justice Statistics.Google Scholar
  51. MacGowan, R. J., Margolis, A., Gaiter, J., Morrow, K., Zack, B., Askew, J., McAuliffe, T., Sosman, J. M., and Eldridge, G. D. (2003). Predictors of risky sex of young men after release from prison. International Journal of STD and AIDS, 14, 519–523.CrossRefPubMedGoogle Scholar
  52. McLellan, A. T., Luborsky, L., Cacciola, J., Griffith, J., McGahan, P., and O'Brien, C. (1985). Guide to the Addiction Severity Index: Background, administration, and field testing results. Washington, DC: U.S. Government Printing Office.Google Scholar
  53. Miller, M., and Paone, D. (1998). Social network characteristics as mediators in the relationship between sexual abuse and HIV risk. Social Science and Medicine, 47(6), 765–777.CrossRefPubMedGoogle Scholar
  54. Miller, M., Paone, D., and Friedmann, P. (1996). The impact of sexual abuse on drug treatment. In Problems of drug dependence: Proceedings from the 1995 CPDD Annual Meeting (NIDA Research Monograph No. 162). Rockville, MD: U.S. Department of Health and Human Services.Google Scholar
  55. Molitor, F., Ruiz, J. D., Klausner, J. D., and McFarland, W. (2000). History of forced sex in association with drug use and sexual HIV risk behaviors, infection with STDs, and diagnostic medical care: Results from the Young Women Survey. Journal of Interpersonal Violence, 15(3), 262–278.CrossRefGoogle Scholar
  56. Morrill, A. C., Kasten, L., Urato, M., and Larson, M. J. (2001). Abuse, addiction, and depression as pathways to sexual risk in women and men with a history of substance abuse. Journal of Substance Abuse, 13, 169–184.CrossRefPubMedGoogle Scholar
  57. Mullings, J. L., Marquart, J. W., and Brewer, V. E. (2000). Assessing the relationship between child sexual abuse and marginal living conditions on HIV/AIDS-related risk behavior among women prisoners. Child Abuse and Neglect, 24(5), 677–688.CrossRefPubMedGoogle Scholar
  58. Mumola, C. (1999a). Substance abuse and treatment, state and federal inmates, 1997. Washington, DC: U.S. Department of Justice, Office of Justice Programs, Bureau of Justice Statistics.Google Scholar
  59. Mumola, C. J. (1999b). Substance abuse and treatment of adults on probation, 1995. Washington, DC: U.S. Department of Justice, Office of Justice Programs, Bureau of Justice Statistics.Google Scholar
  60. Mutter, R. C., Grimes, R. M., and Labarthe, D. (1994). Evidence of intraprison spread of HIV infection. Archives of Internal Medicine, 154, 793–795.CrossRefPubMedGoogle Scholar
  61. New York State Department of Health (2002). HIV infection in prison inmates. Retrieved from the 5.pdf January, 10, 2002Google Scholar
  62. O'Leary, A., Purcell, D., Remien, R. H., and Gomez, C. (2003). Childhood sexual abuse and transmission risk behaviour among HIV-positive men who have sex with men. AIDS Care, 15(1), 17–26.CrossRefPubMedGoogle Scholar
  63. Paul, J. P., Catania, J., Pollack, L., and Stall, R. (2001). Understanding childhood sexual abuse as a predictor of sexual risk-taking among men who have sex with men: The Urban Men's Health Study. Child Abuse and Neglect, 25(4), 557–584.CrossRefPubMedGoogle Scholar
  64. Pérez, D. M. (2000). The relationship between physical abuse, sexual victimization, and adolescent illicit drug use. Journal of Drug Issues, 30(3), 641–662.Google Scholar
  65. Peugh, J., and Belenko, S. (1999). Substance-involved women inmates: Challenges to providing effective treatment, The Prison Journal, 79(1), 23–44.Google Scholar
  66. Peugh, J., and Belenko, S. (2001). Alcohol, drugs, and sexual function: A review. Journal of Psychoactive Drugs, 33(3), 223–232.PubMedGoogle Scholar
  67. Rotheram-Borus, M. J., Mahler, K. A., Koopman, C., and Langabeer, K. (1996). Sexual abuse history and associated multiple risk behavior in adolescent runaways. American Journal of Orthopsychiatry, 66(3), 390–400.PubMedCrossRefGoogle Scholar
  68. Santner, T. J., and Duffy, D. E. (1989). The statistical analysis of discrete data. New York: Springer-Verlag.Google Scholar
  69. Selzer, M. (1971). The Michigan Alcohol Screening Test: The quest for a new diagnostic instrument. American Journal of Psychiatry, 3, 176–181.Google Scholar
  70. Thompson, N. J., Potter, J. S., Sanderson, C. A., and Maibach, E. W. (1997). The relationship of sexual abuse and HIV risk behaviors among heterosexual adult female STD patients. Child Abuse and Neglect, 21(2), 149–156.CrossRefPubMedGoogle Scholar
  71. Widom, C. S., and Ames, M. A. (1994). Criminal consequences of childhood sexual victimization. Child Abuse and Neglect, 18(4), 303–318.CrossRefPubMedGoogle Scholar
  72. Williams, M. L., Zhao, Z., Freeman, R. C., Elwood, W. N., Rusek, R., Booht, R. E., Dennis, M. L., Fisher, D. G., Rhodes, F., and Weatherby, N. L. (1998). A cluster analysis of not-in-treatment drug users at risk for HIV infection. American Journal of Drug and Alcohol Abuse, 24, 199–223.PubMedGoogle Scholar
  73. Wingood, G. M., and DiClemente, R. J. (1997a). Child sexual abuse, HIV sexual risk, and gender relations of African-American women. American Journal of Preventive Medicine, 13(5), 380–384.PubMedGoogle Scholar
  74. Wingood, G. M., and DiClemente, R. J. (1997b). The effects of an abusive primary partner on the condom use and sexual negotiation practices of African-American women. American Journal of Public Health, 87(6), 1016–1018.PubMedGoogle Scholar
  75. Wingood, G. M., and DiClemente, R. J. (1998). The influence of psychosocial factors, alcohol, drug use on African-American women's high-risk sexual behavior. American Journal of Preventive Medicine, 15(1), 54–59.CrossRefPubMedGoogle Scholar
  76. Wyatt, G. E. (1991). Examining ethnicity versus race in AIDS related sex research. Social Science and Medicine, 33, 37–45.CrossRefPubMedGoogle Scholar
  77. Wyatt, G. E., Myers, H. F., Williams, J. K., Kitchen, C. R., Loeb, T., Carmona, J. V., Wyatt, L. E., Chin, D., and Presley, N. (2002). American Journal of Public Health, 92(4), 660–665.PubMedCrossRefGoogle Scholar
  78. Zierler, S., Feingold, L., Laufer, D., Velentgas, P., Kantrowitz, G. I., and Mayer, K. (1991). Adult survivors of childhood sexual abuse and subsequent risk of HIV infection. American Journal of Public Health, 81(5), 572–575.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, Inc. 2005

Authors and Affiliations

  • Steven Belenko
    • 1
    • 5
  • Jeffrey Lin
    • 2
  • Lisa O’Connor
    • 3
  • Hung-En Sung
    • 3
  • Kevin G. Lynch
    • 4
  1. 1.Treatment Research InstituteUniversity of PennsylvaniaPhiladelphiaUSA
  2. 2.Vera Institute of JusticeNew YorkUSA
  3. 3.The National Center on Addiction and Substance AbuseColumbia UniversityNew YorkUSA
  4. 4.Department of Psychiatry, Treatment Research InstituteUniversity of Pennsylvania, University of PennsylvaniaPhiladelphiaUSA
  5. 5.Treatment Research InstituteUniversity of PennsylvaniaPhiladelphiaUSA

Personalised recommendations