Advertisement

Journal of Urban Health

, Volume 88, Issue 2, pp 365–375 | Cite as

Dissolution of Primary Intimate Relationships during Incarceration and Implications for Post-release HIV Transmission

  • Maria R. KhanEmail author
  • Lindy Behrend
  • Adaora A. Adimora
  • Sharon S. Weir
  • Becky L. White
  • David A. Wohl
Article

Abstract

Incarceration is associated with sexually transmitted infections (STIs) including human immunodeficiency virus (HIV). Incarceration may contribute to STI/HIV by disrupting primary intimate relationships that protect against high-risk relationships. Research on sexual network disruption during incarceration and implications for post-release sexual risk behavior is limited. We interviewed a sample of HIV-positive men incarcerated in North Carolina to assess how commonly inmates leave partners behind in the community; characteristics of the relationships; and the prevalence of relationship dissolution during incarceration. Among prison inmates, 52% reported having a primary intimate partner at the time of incarceration. In the period prior to incarceration, 85% of men in relationships lived with and 52% shared finances with their partners. In adjusted analyses, men who did not have a primary cohabiting partner at the time of incarceration, versus those did, appeared to have higher levels of multiple partnerships (adjusted prevalence ratio (PR), 1.5; 95% confidence interval (CI) 0.9–2.6; p = 0.11) and sex trade, defined as giving or receiving sex for money, goods, or services (adjusted PR, 2.1; 95% CI 0.9–4.8; p = 0.08) in the 6 months prior to incarceration. Involvement in financially interdependent partnerships appeared to be associated with further reductions in risk behaviors. Of men in primary partnerships at the time of prison entry, 55% reported their relationship had ended during the incarceration. The findings suggest that involvement in primary partnerships may contribute to reductions in sexual risk-taking among men involved in the criminal justice system but that many partnerships end during incarceration. These findings point to the need for longitudinal research into the effects of incarceration-related sexual network disruption on post-release HIV transmission risk.

Keywords

Incarceration Disruption Sexual networks Primary partnerships Sexual behavior African Americans Southern US North Carolina 

Notes

Acknowledgment

This study was supported by a grant from the University of North Carolina Center for AIDS Research (9P30A150410) and the National Institute of Drug Abuse via RO1 MH068719-01. The conclusions expressed here are solely the responsibility of the authors and do not necessarily represent the views of the funders.

References

  1. 1.
    Maruschak LM. HIV in Prisons, 2007-08. Washington, DC: Department of Justice, Bureau of Justice Statistics. Published December 2009, Revised January 2010. Accessed January 25 2011 at http://bjs.ojp.usdoj.gov/index.cfm?ty=pbdetail&iid=1747.
  2. 2.
    Adimora AA, Schoenbach VJ, Martinson FE, et al. Heterosexually transmitted HIV infection among African Americans in North Carolina. J Acquir Immune Defic Syndr. 2006; 41(5): 616–623.PubMedCrossRefGoogle Scholar
  3. 3.
    Centers for Disease Control and Prevention. HIV Surveillance Report, 2008; vol. 20. Published June 2010. Accessed January 25 2011 at http://www.cdc.gov/hiv/surveillance/resources/reports/2008report/.
  4. 4.
    Hammett TM. HIV/AIDS, sexually transmitted diseases, and incarceration among women: national and southern perspectives. Sex Transm Dis. 2006; 33: S17–S22.PubMedCrossRefGoogle Scholar
  5. 5.
    Manhart LE, Aral SO, Holmes KK, Foxman B. Sex partner concurrency: measurement, prevalence, and correlates among urban 18–39-year-olds. Sex Transm Dis. 2002; 29: 133–143.PubMedCrossRefGoogle Scholar
  6. 6.
    Tyndall MW, Patrick D, Spittal P, Li K, O’Shaughnessy MV, Schechter MT. Risky sexual behaviours among injection drugs users with high HIV prevalence: implications for STD control. Sex Transm Infect. 2002; 78(Suppl 1): i170–i175.PubMedCrossRefGoogle Scholar
  7. 7.
    Adimora AA, Schoenbach VJ, Martinson FE, Donaldson KH, Stancil TR, Fullilove RE. Concurrent partnerships among rural African Americans with recently reported heterosexually transmitted HIV infection. J Acquir Immune Defic Syndr. 2003; 34: 423–429.PubMedCrossRefGoogle Scholar
  8. 8.
    Adimora AA, Schoenbach VJ, Martinson F, Donaldson KH, Stancil TR, Fullilove RE. Concurrent sexual partnerships among African Americans in the rural south. Ann Epidemiol. 2004; 14: 155–160.PubMedCrossRefGoogle Scholar
  9. 9.
    Epperson M, El-Bassel N, Gilbert L, Orellana ER, Chang M. Increased HIV risk associated with criminal justice involvement among men on methadone. AIDS Behav. 2008; 12: 51–57.PubMedCrossRefGoogle Scholar
  10. 10.
    Khan MR, Miller WC, Schoenbach VJ, et al. Timing and duration of incarceration and high-risk sexual partnerships among African Americans in North Carolina. Ann Epidemiol. 2008; 18: 403–410.PubMedCrossRefGoogle Scholar
  11. 11.
    Khan MR, Wohl DA, Weir SS, et al. Incarceration and risky sexual partnerships in a southern US city. J Urban Health. 2008; 85: 100–113.PubMedCrossRefGoogle Scholar
  12. 12.
    Khan MR, Doherty IA, Schoenbach VJ, Taylor EM, Epperson MW, Adimora AA. Incarceration and high-risk sex partnerships among men in the United States. J Urban Health. 2009; 86: 584–601.PubMedCrossRefGoogle Scholar
  13. 13.
    Epperson MW, Khan MR, El-Bassel N, Wu E, Gilbert L. 2010 A longitudinal study of incarceration and HIV risk among methadone maintained men and their primary female partners. AIDS Behav. 2010 Jan 9. [Epub ahead of print].Google Scholar
  14. 14.
    Schneller D. Prisoners’ families: a study of some social and psychological effects of incarceration on the families of Negro prisoners. Criminology. 1975; 12: 402–412.CrossRefGoogle Scholar
  15. 15.
    Lowenstein A. Coping with stress: the case of prisoners’ wives. J Marriage Fam. 1984; 46: 699–708.CrossRefGoogle Scholar
  16. 16.
    Rindfuss R, Stephen EH. Marital noncohabitation: separation does not make the heart grow fonder. J Marriage Fam. 1990; 52: 259–270.CrossRefGoogle Scholar
  17. 17.
    Browning S, Miller S, Lisa M. Criminal incarceration dividing the ties that bind: black men and their families. J Afr Am Men. 2001; 6: 87–102.Google Scholar
  18. 18.
    Comfort M, Grinstead O, McCartney K, Bourgois P, Knight K. “You can’t do nothing in this damn place”: sex and intimacy among couples with an incarcerated male partner. J Sex Res. 2005; 42: 3–12.PubMedCrossRefGoogle Scholar
  19. 19.
    Grinstead O, Zack B, Faigeles B. Reducing postrelease risk behavior among HIV seropositive prison inmates: the health promotion program. AIDS Educ Prev. 2001; 13: 109–119.PubMedCrossRefGoogle Scholar
  20. 20.
    Grinstead OA, Faigeles B, Comfort M, et al. HIV, STD, and hepatitis risk to primary female partners of men being released from prison. Women Health. 2005; 41: 63–80.PubMedGoogle Scholar
  21. 21.
    Morrow KM. HIV, STD, and hepatitis risk behaviors of young men before and after incarceration. AIDS Care. 2009; 21: 235–243.PubMedCrossRefGoogle Scholar
  22. 22.
    Adimora AA, Schoenbach VJ, Bonas DM, Martinson FE, Donaldson KH, Stancil TR. Concurrent sexual partnerships among women in the United States. Epidemiology. 2002; 13: 320–327.PubMedCrossRefGoogle Scholar
  23. 23.
    Adimora AA, Schoenbach VJ, Doherty I. Concurrent sexual partnership among men in the US. Am J Public Health. 2007; 97: 2230–2237.PubMedCrossRefGoogle Scholar
  24. 24.
    Cohen S, Underwood LG, Gotlib BH. Social Support Measurement and Intervention. A Guide for Health and Social Scientists. New York: Oxford University Press; 2000.Google Scholar
  25. 25.
    Kawachi I, Berkman LF. Social ties and mental health. J Urban Health. 2001; 78: 458–467.PubMedGoogle Scholar
  26. 26.
    Simpson JA. The dissolution of romantic relationships: factors involved in relationship stability and emotional distress. J Pers Soc Psychol. 1987; 53: 683–692.CrossRefGoogle Scholar
  27. 27.
    North Carolina Department of Health and Human Services, North Carolina HIV/STD Quarterly Surveillance Report: Vol. 2010, No. 3. Raleigh, NC: Epidemiology Section, Division of Public Health, North Carolina Department of Health & Human Services; October 2010.Google Scholar
  28. 28.
    Zocchetti C, Consonni D, Bertazzi PA. Estimation of prevalence rate ratios from cross-sectional data. Int J Epidemiol. 1995; 24: 1064–1065.PubMedCrossRefGoogle Scholar
  29. 29.
    McNutt LA, Wu C, Xue X, Hafner JP. Estimating the relative risk in cohort studies and clinical trials of common outcomes. Am J Epidemiol. 2003; 157: 940–943.PubMedCrossRefGoogle Scholar
  30. 30.
    Zou G. A modified Poisson regression approach to prospective studies with binary data. Am J Epidemiol. 2004; 159: 702–706.PubMedCrossRefGoogle Scholar
  31. 31.
    Visher C, La Vigne N, Travis J. Returning Home: Understanding the Challenges of Prisoner Reentry, Maryland Pilot Study: Findings from Baltimore. Washington, DC: Urban Institute Justice Policy Center. Published January 2004. Accessed January 25 2011 at http://www.urban.org/uploadedPDF/410974_ReturningHome_MD.pdf.
  32. 32.
    Fountoulakis KN, Leucht S, Kaprinis GS. Personality disorders and violence. Curr Opin Psychiatry. 2008; 21: 84–92.PubMedCrossRefGoogle Scholar
  33. 33.
    Sacks S, Cleland CM, Melnick G, et al. Violent offenses associated with co-occurring substance use and mental health problems: evidence from CJDATS. Behav Sci Law. 2009; 27: 51–69.PubMedCrossRefGoogle Scholar
  34. 34.
    Haley D, Scheyett A, Golin C, et al. BRIGHT project qualitative substudy: perceptions of release among incarcerated HIV-infected persons and implications for practice. Paper presented at: XVI International AIDS Conference. August 2006; Toronto, Canada.Google Scholar

Copyright information

© The New York Academy of Medicine 2010

Authors and Affiliations

  • Maria R. Khan
    • 1
    Email author
  • Lindy Behrend
    • 2
  • Adaora A. Adimora
    • 3
  • Sharon S. Weir
    • 4
  • Becky L. White
    • 5
  • David A. Wohl
    • 6
  1. 1.Department of Epidemiology and Biostatistics, School of Public HealthUniversity of Maryland at College ParkCollege ParkUSA
  2. 2.Center for Health Promotion and Disease PreventionUniversity of North Carolina at Chapel HillChapel HillUSA
  3. 3.Division of Infectious Diseases, School of Medicine and Department of Epidemiology, School of Public HealthUniversity of North Carolina at Chapel HillChapel HillUSA
  4. 4.Department of Epidemiology, School of Public HealthUniversity of North Carolina at Chapel HillChapel HillUSA
  5. 5.Division of Infectious Diseases, School of MedicineUniversity of North Carolina at Chapel HillChapel HillUSA
  6. 6.Division of Infectious Diseases, School of Medicine and Center for AIDS ResearchUniversity of North Carolina at Chapel HillChapel HillUSA

Personalised recommendations