Estimating the Influence of Incarceration on Subsequent Experience With Violence Among Black Men Who Have Sex With Men in the HPTN061 Study

Abstract

Black men who have sex with men (BMSM) are disproportionately incarcerated in the United States. Incarceration is a barrier to health equity and may be a risk factor for experiences of interpersonal violence. However, the effect of incarceration on experienced violence among BMSM is understudied. We examined associations between recent incarceration on subsequent experiences of race- or sexuality-based violence, intimate partner violence, or community violence. We analyzed data from the HPTN 061 study. Analysis includes data on 1,169 BMSM recruited from 6 U.S. cities who were present at baseline as well as 6- and 12-month follow-up interview. We tested if self-reported incarceration between baseline and 6 months was associated with self-reported outcomes between 6 and 12 months using logistic regression with inverse probability of treatment weighting and multiple imputation methods. Experienced outcomes included violence due to race or sexuality, intimate partner violence and aggression, and community violence (i.e., gang violence, robbery, shooting). Approximately 14% reported incarceration between baseline and 6 months and 90% reported experiencing violence between 6 and 12 months. In adjusted analyses, incarceration was associated with subsequent race- or sexuality-based violence [a OR (adjusted odds ratio) range: 1.25-1.41, 95% CI (confidence interval) range: 1.00-1.74], experiences of physical abuse and aggression from intimate partners (a OR: 2.35; 95% CI: 1.50, 3.70) and community violence ( OR 1.82; 95% CI: 1.23, 2.72). Recent incarceration experience increased risk of exposure to future violence in this population. Mixed methods research examining mediating paths between and downstream effects of incarceration and violence on the wellbeing and health of BMSM is needed. We implore researchers to study violence and incarceration among BMSM. Practitione should implement strategies such as trauma-informed interventions, and policies strengthening the social and economic support needs of Black populations.

Characterisation of social support following incarceration among black sexual minority men and transgender women in the HPTN 061 cohort study

“…Psychosocial covariates included self-reported hard drug use32 (ie, heroin, crack/cocaine, methamphetamine, prescription misuse or other drugs) in the past 6 months; weekly marijuana use; currently has health coverage; lifetime incarceration; Alcohol Use Disorders Identification Test score33 34; depressive symptoms based on Centres for Epidemiologic Studies-Depression scale35; physical and/or threatened violence due to race and/or sexuality, which is defined as reporting being threatened with and/or experiencing physical violence (ie, punched, kicked, beaten) that the participant attributed was due to their race and their sexuality36; perceived racism and homophobia, which was measured using items from the Racism and Life Experience Scales- Daily Life Experiences scale, with 20 items each regarding experiences related to race and sexuality such as being ignored or not given the same service37 38; and internalised homophobia, which was assessed by summing responses to a 7-item scale regarding how strongly participants agreed with statements such as ‘I wish I weren’t attracted to men,’ and ‘As a Black man, I try to act more masculine to hide my sexuality.’39 40 STI/HIV risk covariates including reporting sex with female partners in the past 6 months41; having received HIV testing32; transactional sex in the past 6 months; multiple partnerships defined as higher than the median (≥3)42; concurrent partnership defined as partners in addition to their primary partner in the past 6 months and currently cohabiting with primary partner.…”

Impact of Decarceration Plus Alcohol, Substance Use, and Mental Health Screening on Life Expectancies of Black Sexual Minority Men and Black Transgender Women Living With HIV in the United States: A Simulation Study Based on HPTN 061

“…7 Structural racism contributes greatly to these disparities in incarceration rates. 8,9 Incarceration has been associated with several negative outcomes among BSMM including elevated risks of unhealthy alcohol and drug use, 10 violence, 11 mental disorders, 12 and increased risk of HIV acquisition. 13 In addition, it is well known that incarceration is associated with disruption in care or lack of care for different health-related conditions.…”