Skip to main content

Advertisement

SpringerLink
Log in

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

  • Published:
Journal of Urban Health Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  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. 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.

    Article  PubMed  Google Scholar 

  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. Hammett TM. HIV/AIDS, sexually transmitted diseases, and incarceration among women: national and southern perspectives. Sex Transm Dis. 2006; 33: S17–S22.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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].

  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.

    Article  Google Scholar 

  15. Lowenstein A. Coping with stress: the case of prisoners’ wives. J Marriage Fam. 1984; 46: 699–708.

    Article  Google Scholar 

  16. Rindfuss R, Stephen EH. Marital noncohabitation: separation does not make the heart grow fonder. J Marriage Fam. 1990; 52: 259–270.

    Article  Google Scholar 

  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. 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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  CAS  Google Scholar 

  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.

    PubMed  Google Scholar 

  21. Morrow KM. HIV, STD, and hepatitis risk behaviors of young men before and after incarceration. AIDS Care. 2009; 21: 235–243.

    Article  PubMed  CAS  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  23. Adimora AA, Schoenbach VJ, Doherty I. Concurrent sexual partnership among men in the US. Am J Public Health. 2007; 97: 2230–2237.

    Article  PubMed  Google Scholar 

  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. Kawachi I, Berkman LF. Social ties and mental health. J Urban Health. 2001; 78: 458–467.

    PubMed  CAS  Google Scholar 

  26. Simpson JA. The dissolution of romantic relationships: factors involved in relationship stability and emotional distress. J Pers Soc Psychol. 1987; 53: 683–692.

    Article  Google Scholar 

  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.

  28. Zocchetti C, Consonni D, Bertazzi PA. Estimation of prevalence rate ratios from cross-sectional data. Int J Epidemiol. 1995; 24: 1064–1065.

    Article  PubMed  CAS  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  30. Zou G. A modified Poisson regression approach to prospective studies with binary data. Am J Epidemiol. 2004; 159: 702–706.

    Article  PubMed  Google Scholar 

  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. Fountoulakis KN, Leucht S, Kaprinis GS. Personality disorders and violence. Curr Opin Psychiatry. 2008; 21: 84–92.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

Download references

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.

Author information

Authors and Affiliations

  1. Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland at College Park, College Park, MD, USA

    Maria R. Khan

  2. Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Lindy Behrend

  3. Division of Infectious Diseases, School of Medicine and Department of Epidemiology, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Adaora A. Adimora

  4. Department of Epidemiology, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Sharon S. Weir

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

    Becky L. White

  6. Division of Infectious Diseases, School of Medicine and Center for AIDS Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    David A. Wohl

Authors
  1. Maria R. Khan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Lindy Behrend
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Adaora A. Adimora
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sharon S. Weir
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Becky L. White
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. David A. Wohl
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Maria R. Khan.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Khan, M.R., Behrend, L., Adimora, A.A. et al. Dissolution of Primary Intimate Relationships during Incarceration and Implications for Post-release HIV Transmission. J Urban Health 88, 365–375 (2011). https://doi.org/10.1007/s11524-010-9538-1

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11524-010-9538-1

Keywords

Search

Navigation