Examining the Temporal Relationship Between Criminal Justice Involvement and Sexual Risk Behaviors among Drug-Involved Men

Abstract

Although criminal justice involvement has repeatedly been associated with human immunodeficiency virus (HIV)/sexually transmitted infection prevalence and sexual risk behaviors, few studies have examined whether arrest or incarceration uniquely contributes to sexually risky behavior. We examined the temporal relationship between criminal justice involvement and subsequent sexual HIV risk among men in methadone maintenance treatment in New York City. A random sample of 356 men was interviewed at baseline (time 1), 6-month (time 2), and 12-month (time 3) followups. Propensity score matching, negative binomial, and multiple logistic regression were used to isolate and test the effect of time 2 arrest and incarceration on time 3 sexual risk behaviors. Incidence of time 2 criminal justice involvement was 20.1% for arrest and 9.4% for incarceration in the prior 6 months. Men who were arrested at time 2 demonstrated increased number (adjusted incidence rate ratio [IRR]=1.62; 95% confidence intervals [CI]=1.11, 2.37) and proportion (IRR=1.36; 95% CI=1.07, 1.72) of unprotected vaginal sex acts at time 3. Men incarcerated at time 2 displayed increased number (IRR=2.07; 95% CI=1.23, 3.48) and proportion (IRR=1.45; 95% CI=1.06, 1.99) of unprotected vaginal sex acts at time 3. Within this sample of druginvolved men, arrest and incarceration are temporally associated with and may uniquely impact successive sexual risk-taking. Findings underscore the importance of HIV prevention interventions among individuals with low-intensity criminal justice involvement. Developing prevention efforts aimed at short-term incarceration, community reentry, and alternatives to incarceration settings will address a large and underresearched segment of the criminal justice population. Alternative approaches to current criminal justice policy may result in public health benefits.

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

“…Heterosexual African Americans with a history of incarceration are six times more likely to be HIV-infected than those with no incarceration history (8); substantial proportions of HIV-infected African Americans pass through a correctional facility annually (9), and other STIs are likewise high among inmates in prisons and jails (10). Further, studies across numerous populations, including in predominantly African American samples, suggest a history of incarceration is a strong and consistent independent risk factor for sexual risk behavior and STI/HIV (11–14). While the structural violence of mass incarceration is likely an important driver of STI/HIV risk among African Americans, other modifiable factors that increase risk for infection among African Americans involved in the criminal justice system also are likely to play an important role.…”

HIV-Related Sexual Risk among African American Men Preceding Incarceration: Associations with Support from Significant Others, Family, and Friends

“…Individuals who pass through jails and prisons in the USA face disproportionate risk of HIV infection, both before incarceration and after release [1][2][3][4]. During re-entry into the community after incarceration, individuals must reestablish independence, employment, housing, and relationships.…”

“…During re-entry into the community after incarceration, individuals must reestablish independence, employment, housing, and relationships. The stress associated with re-entry may amplify risk of HIV through sexual risk-taking or drug use that existed prior to incarceration [2,4,5]. Improved understanding of factors that may protect individuals involved in the criminal justice system against engaging in HIV risk behaviors in their community remains an important public health priority [2,6] The social support networks that inmates leave behind and to which they return may promote well-being and reduce sexual behaviors that drive HIV risk.…”

Dual Incarceration and Condom Use in Committed Relationships

“…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).…”