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Incarceration and Risky Sexual Partnerships in a Southern US City

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Abstract

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.

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Acknowledgments

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.

The authors thank Sherri Harris and Sandy Michael of NIA Community Action Center, Willie Garrison of the Wright Focus Group, and Nancy Jackson of the UNC-CH Center for AIDS Research for their leadership in the field and insights into study findings; all members of the NC PLACE Steering Committee for guidance and support through the study planning, implementation, and dissemination; the NC PLACE Study interviewing team members for their diligence; and members of the UNC-CH Bridges to Good Health and Treatment (BRIGHT) Working Group for their consistent support during NC PLACE field and data analysis activities, with particular thanks to Monique Williams, Tracina Williams, Danielle Haley, Becky Stephenson-White, Anna Scheyette, Carol Golin, and Andrew Kaplan. We dedicate this research to the memories of Andrew Kaplan and Willie Garrison, who continue to inspire our efforts to prevent HIV transmission in North Carolina and beyond.

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Authors and Affiliations

  1. Department of Epidemiology, School of Public Health, University of North Carolina, CB 7435, Chapel Hill, NC, 27514, USA

    Maria R. Khan MPH, Doctoral Candidate, Sharon S. Weir, Adaora A. Adimora, Jay S. Kaufman & William C. Miller

  2. Center for AIDS Research, University of North Carolina, Chapel Hill, NC, USA

    David A. Wohl

  3. Division of Infectious Diseases, School of Medicine, University of North Carolina, Chapel Hill, NC, USA

    David A. Wohl, Adaora A. Adimora & William C. Miller

  4. The MEASURE Evaluation Project, Carolina Population Center, University of North Carolina, Chapel Hill, NC, USA

    Sharon S. Weir

  5. Guilford County Department of Public Health, Greensboro, NC, USA

    Caroline Moseley

  6. Sickle Cell Disease Association of the Piedmont, Guilford County, NC, USA

    Kathy Norcott

  7. Triad Health Project, Guilford County, NC, USA

    Jesse Duncan

Authors
  1. Maria R. Khan MPH, Doctoral Candidate
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  2. David A. Wohl
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  3. Sharon S. Weir
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  4. Adaora A. Adimora
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  5. Caroline Moseley
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  6. Kathy Norcott
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  7. Jesse Duncan
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  8. Jay S. Kaufman
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  9. William C. Miller
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Corresponding author

Correspondence to Maria R. Khan MPH, Doctoral Candidate.

Additional information

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.

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Khan, M.R., Wohl, D.A., Weir, S.S. et al. Incarceration and Risky Sexual Partnerships in a Southern US City. J Urban Health 85, 100–113 (2008). https://doi.org/10.1007/s11524-007-9237-8

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  • DOI: https://doi.org/10.1007/s11524-007-9237-8

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