Elevated Sexual Risk Behaviors Among Postincarcerated Young African American Males in the South

Abstract

The dramatic racial disparities in the rates of HIV/STIs among African Americans make understanding broader structural factors that increase the risk for HIV/STIs crucial. The current study of young 564 African American men attending sexually transmitted infection (STI) clinics investigated whether those who had ever been incarcerated reported recent sexual behaviors relatively more risky than their counterparts who had never been incarcerated. Participants were recruited from clinics treating STIs in three southern U.S. cities. Males 15–23 years of age who identified as Black/African American and reported recent (past two months) sexual activity were eligible. Linear mixed-effects models and Generalized Estimating Equation (GEE) models were used to assess associations between baseline incarceration history and sexual risk behavior over a 6-month follow-up period. Mean age was 19.6 years (SD=1.87). At baseline, 240 (42.6%) men reported history of incarceration. Incarceration history predicted several risk behaviors over a 6-month follow-up period. Compared to those with no incarceration history, men previously incarcerated reported a desire to conceive a pregnancy (β=.40, p=.02), were less likely to have used a condom at last sex act (OR=.91, p=.02) and were more likely to have used drugs and alcohol before sex in the past two months (β=.69, p<.001; β=.41, p<.001). A history of incarceration may influence the sexual risk behavior of young African American males. Prevention programs and interventions should intensify support for post-incarceration African American males to help mitigate this behavior.

Dual Incarceration and Condom Use in Committed Relationships

“…Our focus on how dual incarceration impacts condom use expands on earlier work examining how both an individual’s incarceration and an individual’s sexual partner’s incarceration each affect unprotected sex (7, 11–13, 15, 18). These earlier studies describe how the movement of one individual in and out of incarceration affects ties within a relationship, and how, in turn, this impacts condom use in the partnership.…”

“…One particular consequence that extends beyond the walls of the institution is increased risk of HIV infection (5–7). One theoretical rationale for this increased risk is that the constant movement of individuals in and out of jails, or their ‘involuntary mobility,’ contributes to social disorganization in neighborhoods and subsequently impacts both health and crime in these neighborhoods (5, 8, 9).…”

“…As applied to HIV risk, this ‘involuntary mobility’ may disrupt individuals’ intimate relationships, which can then affect their sexual behavior (5), and in particular, their condom use. In two separate prospective studies with convenience samples of males at high risk of HIV infection, having been recently incarcerated or having a history of incarceration predicted unprotected sex (6, 7). Similarly, in a population-based cross sectional study of men who had no history of illicit drug use, those who had recently been incarcerated were significantly more likely to report unprotected sex than those who had not recently been incarcerated (10).…”

Mobile screening to identify and follow-up with high Risk, HIV negative youth

“…4 Young MSM, and in particular young Black MSM, not only face increased risk due to unprotected sexual behaviors, but also because many have older sexual partners who are more likely to be HIV positive. 1,2 Youth with substance use disorders face increased risk if they inject drugs, and also because heavy drinking, marijuana use, and illicit drug use may be associated with a greater number of sexual partners, and with less frequent condom use.…”

“…5 Young men who have recently been incarcerated report more frequent unprotected sex, and are more likely to report having sex while under the influence of drugs and alcohol than those not recently incarcerated. 4 …”