Sexual Risk and Criminal Justice Involvement Among Women Who Use Drugs

  • Andrea K. KnittelEmail author
  • Barrot H. Lambdin
  • Megan L. Comfort
  • Alex H. Kral
  • Jennifer Lorvick
Original Paper


Criminal justice system involvement among US women is associated with increased risk for HIV/sexually transmitted infections, yet effects of different forms of criminal justice involvement on intimate relationships are not well understood. This study examined associations between arrest, probation, and jail incarceration on the number of sexual partners, sexual concurrency, and consistent condom use for drug-using women (n = 631) in Oakland, California. We used logistic and negative binomial regression and adjusted for demographics, sex exchange and drug use. Probation was associated with higher rates of sexual partnership and concurrency (IRR 1.87, 95% CI [1.11, 3.15]; OR 3.64, 95% CI [1.08, 12.20]). Incarceration lasting over 12 weeks was associated with higher rates of sexual partnership (IRR 2.23, 95% CI [1.41, 3.51]). Women incarcerated once in the past year had higher odds of concurrency (OR 2.15, 95% CI [1.01, 4.57]). Our results reinforce the need for risk-reduction interventions and criminal justice diversion for women who use drugs.


Incarceration Sexual health Sexual behavior Drug use 


Involucramiento de mujeres estadounidenses en el sistema de justicia penal está asociado con riesgo aumentado de VIH/ITS, aunque los efectos de las formas diferentes de involucramiento en la justicia penal en las relaciones íntimas no se comprenden bien. Este estudio examinó las asociaciones entre el arresto, la libertad condicional y el encarcelamiento de la cárcel y el número de parejas sexuales, la concurrencia sexual, y el uso consistente de condones para mujeres que consumen drogas (n = 631) en Oakland, California. Utilizamos regresión logística y binomial negativa y se ajustamos para la demografía, el intercambio sexual y el uso de drogas. La libertad condicional se asoció con tasas más altas de parejas sexuales y concurrencia (IRR 1.87, IC del 95% [1.11, 3.15]; OR 3.64, IC del 95% [1.08, 12.20]). El encarcelamiento más de 12 semanas se asoció con tasas más altas de parejas sexuales (IRR 2.23, 95% CI [1.41, 3.51]). Las mujeres que habían sido encarceladas una vez en el último año tenían mayores probabilidades de concurrencia (OR 2.15, IC del 95% [1.01, 4.57]). Nuestros resultados refuerzan la necesidad de intervenciones enfocadas en la reducción de riesgo y el desvío del sistema de justicia penal para las mujeres que consumen drogas.



The work of Drs. Lambdin, Comfort, Kral, and Lorvick on this study was supported by a Grant from NIMHD (RO1MD007679). Dr. Knittel received support from the University of North Carolina at Chapel Hill Center for AIDS Research (CFAR), an NIH Funded Program (P30 AI50410). The authors would like to thank Ms. Reana Thomas for her assistance with manuscript preparation.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Division of General Obstetrics and Gynecology, Department of Obstetrics and GynecologyUniversity of North CarolinaChapel HillUSA
  2. 2.Division of Behavioral Health and Criminal JusticeRTI InternationalSan FranciscoUSA
  3. 3.Community Health and Implementation Research ProgramRTI InternationalSan FranciscoUSA

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