HIV Transmission Behaviors in Jail/Prison Among Puerto Rican Drug Injectors in New York and Puerto Rico

Abstract

This study examined HIV risk behavior in jail/prison among Puerto Rican drug injectors in New York (NY, n = 300) and Puerto Rico (PR, n = 200), and its relationship with later drug and sex risk behaviors. During 3 years prior to interview, 66% of NY and 43% of PR samples were incarcerated at least once. While incarcerated, 5% of NY and 53% of PR injected drugs. Few reported engaging in sex inside jail/prison (5% in both sites). Of those who engaged in risk behaviors in jail/prison, almost all reported having unprotected sex and sharing injection equipment. The impact of jail/prison risk behaviors on risk behaviors after release differed between the two sites: they were more related to subsequent sex risk behaviors in NY, and subsequent injection risk behaviors in PR. The findings indicate a need for effective drug treatment programs inside jail/prisons to reduce HIV-related risk behaviors among drug injectors during incarceration and after release.

Substance Use and Sexual Behavior during Incarceration among 18- to 29-Year Old Men: Prevalence and Correlates

“…Our findings also support prior research suggesting that substance use and consensual sexual behavior practices during incarceration may reflect behavioral practices in the community (Clarke et al, 2001;Kang et al, 2005;Moseley & Tewksbury 2006;Seal et al, 2004;Wohl et al, 2000). In particular, our data indicate a relationship between hard drug use before incarceration and substance use during incarceration, an a Variables significant in univariate analyses were entered into a separate multivariate logistic regression model b Behaviors occurring in the community during a 3-month reporting period before incarceration c PCP, ecstasy, hallucinogens, amphetamines, crack cocaine, powder cocaine, heroin, speedball, sedatives, or any other drugs excluding marijuana d Sex (oral, vaginal, or anal) prohibited by the correctional facility (i.e., non-conjugal visits) e Stab wound, broken bones, teeth knock out/broken, knocked unconscious, heavy bleeding association that was not evident for men whose substance use in the community was limited to alcohol and/or marijuana (data not shown).…”

“…Research has further indicated that the use of drugs or alcohol during incarceration is widespread, and the majority of men who use substances do so on multiple occasions Clarke et al, 2001;Inciardi, Lockwood, & Quinlan, 1993;Kang et al, 2005;Krebs & Simmons, 2002;Seal et al, 2004;Stephens et al, 1999;Wohl et al, 2000). Marijuana and alcohol are the most universally used substances in correctional facilities.…”

“…Most studies also have documented the use of other drugs, including those which are injected, although the prevalence of drug use other than marijuana varies considerably across regions and types of correctional facilities. Among men who inject drugs while incarcerated in the United States, needle sharing is common, while needle cleaning behavior is rare Inciardi et al, 1993;Kang et al, 2005;Seal et al, 2004).…”

“…Across studies, variables that have been found to be associated with substance use or coercive or non-coercive sexual behavior during incarceration include being White, being less educated, identifying as transgendered, being affiliated with a gang, and having spent a greater number of years in a correctional facility Beck & Harrison, 2006;Hensley et al, 2001;Kang et al, 2005;Moseley & Tewksbury, 2006;Robertson, 2003;Seal et al, 2004;Stephens et al, 1999;Struckman-Johnson et al, 1996). Other studies have shown that men who engage in high-risk behaviors (e.g., anal sex without a condom, injection drug use) in the community prior to incarceration are more likely to also engage in risk behavior during incarceration (Clarke et al, 2001;Kang et al, 2005;Moseley & Tewksbury, 2006).…”

Estimating the Prevalence of Injection Drug Use among Black and White Adults in Large U.S. Metropolitan Areas over Time (1992–2002): Estimation Methods and Prevalence Trends

“…Notably, while this mass exodus would have reduced Black IDU prevalence within MSAs, ample evidence indicates that this migration harms both incarcerated individuals and the communities in which they are embedded and that people may resume injecting post-release. [117][118][119][120][121][122] Together, AIDS-related deaths and prison admissions may, in epidemiologic terms, have reduced the "case duration" of injecting among Black adults during the study period.…”