Abstract
We evaluated the association between social support received from significant others, family, and friends and HIV-related sexual risk behaviors among African American men involved in the criminal justice system. Project DISRUPT is a cohort study among African American men released from prison in North Carolina (N = 189). During the baseline (in-prison) survey, we assessed the amount of support men perceived they had received from significant others, family, and friends. We measured associations between low support from each source (<median value) and participants’ sex risk in the 6 months before incarceration. Low levels of social support from significant others, family, or friends were associated with poverty and homelessness, mental disorders, and substance use. Adjusting for age, poverty, and other sources of support, perceiving low support from significant others was strongly associated with multiple partnerships (fully adjusted odds ratio (OR) 2.64, 95% confidence interval (CI) 1.29–5.42). Low significant other support also was strongly associated with sex trade involvement when adjusting for age and poverty status (adjusted OR 3.51, 95% CI 1.25–9.85) but further adjustment for low family and friend support weakened the association (fully adjusted OR 2.81, 95% CI 0.92–8.55). Significant other support was not associated with other sex risk outcomes including concurrent partnerships, anal sex, or sex with an STI/HIV-infected partner. Low family support was associated with multiple partnerships in analyses adjusting for age and poverty (adjusted OR 1.98, 95% CI 1.05–3.76) but the association weakened and was no longer significant after adjusting for other sources of support (fully adjusted OR 1.40, 95% CI 0.65–3.00); family support was not correlated with other risk behaviors. Friend support was not significantly associated with sex risk outcomes. Indicators of overall support from any source were not associated with sex risk outcomes. Helping inmates maintain ties may improve economic security and well-being during community re-entry, while supporting and strengthening relationships with a significant other in particular may help reduce sex risk. Studies should evaluate the protective effects of distinct support sources to avoid masking effects of support and to best understand the influence of social support on health.
Similar content being viewed by others
References
Khan MR, Epperson MW, Mateu-Gelabert P, Bolyard M, Sandoval M, Friedman SR. Incarceration, sex with an STI- or HIV-infected partner, and infection with an STI or HIV in Bushwick, Brooklyn, NY: a social network perspective. Am J Public Health. 2011; 101(6): 1110–7.
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(4): 584–601.
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(1): 51–7.
Epperson M, El-Bassel N, Gilbert L, Chang M. Examining the temporal relationship between criminal justice involvement and sexual risk behaviors among drug-involved men. J Urban Health. 2010; 87(2): 324–36.
Harawa N, A A. Incarceration, African Americans, and HIV: advancing a research agenda. J Natl Med Assoc. 2008;100(1):57–62.
Adams LM, Kendall S, Smith A, Quigley E, Stuewig JB, Tangney JP. HIV risk behaviors of male and female jail inmates prior to incarceration and one year post-release. AIDS Behav. 2013; 17: 2685–94.
Kawachi I, Berkman LF. Social ties and mental health. J Urban Health. 2001; 78(3): 458–67.
Grieb SM, Crawford A, Fields J, Smith H, Harris R, Matson P. “The stress will kill you”: prisoner reentry as experienced by family members and the urgent need for support services. J Health Care Poor Underserved. 2014; 25(3): 1183–200.
Western B, Braga AA, Davis J, Sirois C. Stress and hardship after prison. AJS. 2015; 120(5): 1512–47.
Anderson RE, Geier TJ, Cahill SP. Epidemiological associations between posttraumatic stress disorder and incarceration in the National Survey of American Life. Crim Behav Ment Health. 2016; 26(2): 110–123.
Brady SS, Dolcini MM, Harper GW, Pollack LM. Supportive friendships moderate the association between stressful life events and sexual risk taking among African American adolescents. Health Psychol. 2009; 28(2): 238–48.
Kunitz SJ. Social capital and health. Br Med Bull. 2004; 69: 61–73.
Visher C, La Vigne NG, Travis J. Returning Home: Understanding the Challenges of Prisoner Reentry, Maryland Pilot Study: Findings from Baltimore. Washington, DC: Urban Institute Justice Policy Center; 2004.
Ramrakha S, Caspi A, Dickson N, Moffitt TE, Paul C. Psychiatric disorders and risky sexual behaviour in young adulthood: cross sectional study in birth cohort. BMJ. 2000; 321(7256): 263–6.
Mazzaferro KE, Murray PJ, Ness RB, Bass DC, Tyus N, Cook RL. Depression, stress, and social support as predictors of high-risk sexual behaviors and STIs in young women. J Adolesc Health. 2006; 39(4): 601–3.
Khan MR, Kaufman JS, Pence BW, et al. Depression, sexually transmitted infection, and sexual risk behavior among young adults in the United States. Arch Pediatr Adolesc Med. 2009; 163(7): 644–52.
Santelli JS, Robin L, Brener ND, Lowry R. Timing of alcohol and other drug use and sexual risk behaviors among unmarried adolescents and young adults. Fam Plann Perspect. 2001; 33(5): 200–5.
Qiao S, Li X, Stanton B. Social support and HIV-related risk behaviors: a systematic review of the global literature. AIDS Behav. 2014; 18: 419–41.
Seal DW, Eldrige GD, Kacanek D, Binson D, Macgowan RJ. A longitudinal, qualitative analysis of the context of substance use and sexual behavior among 18- to 29-year-old men after their release from prison. Soc Sci Med. 2007; 65(11): 2394–406.
Johnson JE, Esposito-Smythers C, Miranda R Jr, Rizzo CJ, Justus AN, Clum G. Gender, social support, and depression in criminal justice involved adolescents. Int J Offender Ther Comp Criminol. 2011; 55(7): 1096–109.
Munoz-Laboy M, Severson N, Perry A, Guilamo-Ramos V. Differential impact of types of social support in the mental health of formerly incarcerated Latino men. Am J Mens Health. 2013.
Feaster DJ, Grinstead Reznick O, Zach B, McCartney K, Gregorich SE, Brincks AM. Health status, sexual and drug risk, and psychosocial factors relevant to postrelease planning for HIV+ prisoners. J Correct Health Care. 2013; 19(4): 278–92.
Khan MR, Behrend L, Adimora AA, Weir SS, White BL, Wohl DA. Dissolution of primary intimate relationships during incarceration and implications for post-release HIV transmission. J Urban Health. 2011; 88(2): 365–75.
Harman JJ, Smith VE, Egan LC. The impact of incarceration on intimate relationships. Crim Justice Behav. 2007; 34: 794–815.
Khan MR, Behrend L, Adimora AA, Weir SS, Tisdale C, Wohl DA. Dissolution of primary intimate relationships during incarceration and associations with post-release STI/HIV risk behavior in a southeastern city. Sex Transm Dis. 2011; 38(1): 43–7.
Unger JB, Kipke MD, De Rosa CJ, Hyde J, Ritt-Olson A, Montgomery S. Needle-sharing among young IV drug users and their social network members: the influence of the injection partner’s characteristics on HIV risk behavior. Addict Behav. 2006; 31(9): 1607–18.
Miller M, Neaigus A. Sex partner support, drug use and sex risk among HIV-negative non-injection heroin users. AIDS Care. 2002; 14(6): 801–13.
Adimora AA, Schoenbach VJ, Doherty IA. Concurrent sexual partnerships among men in the United States. Am J Public Health. 2007; 97(12): 2230–7.
Adimora AA, Schoenbach VJ, Bonas DM, Martinson FE, Donaldson KH, Stancil TR. Concurrent sexual partnerships among women in the United States. Epidemiology. 2002; 13(3): 320–7.
Arditti JA. Families and incarceration: an ecological approach. Fam Soc. 2005; 86(2): 251–60.
Perkins-Dock RE. Family interventions with incarcerated youth: a review of the literature. Int J Offender Ther Comp Criminol. 2001; 45(5): 606–25.
Crosby RA, DiClemente RJ, Wingood GM, et al. HIV/STD-protective benefits of living with mothers in perceived supportive families: a study of high-risk African American female teens. Prev Med. 2001; 33(3): 175–8.
Williams CT, Latkin CA. The role of depressive symptoms in predicting sex with multiple and high-risk partners. J Acquir Immune Defic Syndr. 2005; 38(1): 69–73.
Seal DW, Margolis AD, Sosman J, Kacanek D, Binson D, The Project START Study Group. HIV and STD risk behavior among 18- to 25-year-old men released from U.S. prisons: provider perspectives. AIDS Behav. 2003;7(2):131–141.
Carlos JA, Bingham TA, Stueve A, et al. The role of peer support on condom use among black and latino MSM in three urban areas. AIDS Educ Prev. 2010; 22(5): 430–44.
U.S. Department of Health and Human Services. Incarceration and the family: a review of research and promising approaches for serving fathers and families. 2008. Research Triangle Park, North Carolina.
Khan MR, Golin CE, Friedman SR, et al. STI/HIV sexual risk behavior and prevalent STI among incarcerated African American men in committed partnerships: the significance of poverty, mood disorders, and substance use. AIDS Behav. 2015; 19(8): 1478–90.
Zimet GD, Dahlem NW, Zimet SG, Farley GK. The multidemensional scale of perceived social support. J Pers Assess. 1988; 52(1): 30–41.
Pedersen SS, Spinder H, Erdman RAM, Denollet J. Poor perceived social support in implantable cardioverter defibrillator (ICD) patients and their partners: cross-validation of the multidimensional scale of perceived social support. Psychosomatics. 2009; 50(5): 461–7.
Wu JR, Frazier SK, Rayens MK, Lennie TA, Chung ML, Moser DK. Medication adherence, social support, and event-free survival in patients with heart failure. Health Psychol. 2013; 32(6): 637–46.
Radloff L. The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Meas. 1977; 1: 385–401.
Coogan PF, Yu J, O’Conner GT, Brown TA, Palmer JR, Rosenberg L. Depressive symptoms and the incidence of adult-onset asthma in African American women. Ann Allergy Asthma Immunol. 2014.
Spielberger CD, Gorsuch RL, Lushene RE. Manual for the State‐Trait Anxiety Inventory. Palo Alto, CA: Consulting Psychologists Press; 1970.
Kruyen PM, Emons WHM, Sijtsma K. Shortening the S-STAI: consequences for research and clinical practice. J Psychosom Res. 2009; 75: 167–72.
Grewen KM, Girdler SS, Amico J, Light KC. Effects of partner support on resting oxytocin, cortisol, norepinephrine, and blood pressure before and after warm partner contact. Psychosom Med. 2005; 67: 531–8.
Manzoli L, Villari P, Pirone GM, Boccia A. Marital status and mortality in the elderly: a systematic review and meta-analysis. Soc Sci Med. 2007; 64(1): 77–94.
Visher CA. Incarcerated fathers: pathways from prison to home. Crim Justice Policy Rev. 2013; 24(1): 9–26.
Freudenberg N, Ramaswamy M, Daniels J, Crum M, Ompad DC, Vlahov D. Reducing drug use, human immunodeficiency virus risk, and recidivism among young men leaving jail: evaluation of the REAL MEN re-entry program. J Adolesc Health. 2010; 47: 448–55.
Grinstead OA, Zack B, Faigeles B, Grossman N, Blea L. Reducing postrelease HIV risk among male prison inmates: a peer-led intervention. Crim Justice Behav. 1999; 26(4): 453–65.
Grinstead O, Zack B, Faigeles B. Reducing postrelease risk behavior among HIV seropositive prison inmates: the health promotion program. AIDS Educ Prev. 2001; 13(2): 109–19.
Wolitski RJ. Relative efficacy of a multisession sexual risk-reduction intervention for young men released from prisons in 4 states. Am J Public Health. 2006; 96(10): 1854–61.
Acknowledgments
This study was supported by R01DA028766 (Relationship Disruption During Incarceration and HIV Risk in African American Men; PI: Khan).
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
This study was approved by the Institutional Review Boards of the University of North Carolina at Chapel Hill, University of Florida, New York University School of Medicine, and NCDPS.
Rights and permissions
About this article
Cite this article
Coatsworth, A.M., Scheidell, J.D., Wohl, D.A. et al. HIV-Related Sexual Risk among African American Men Preceding Incarceration: Associations with Support from Significant Others, Family, and Friends. J Urban Health 94, 136–148 (2017). https://doi.org/10.1007/s11524-016-0120-3
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11524-016-0120-3