Partner Incarceration and African-American Women’s Sexual Relationships and Risk: A Longitudinal Qualitative Study

Abstract

Racialized mass incarceration is associated with racial/ethnic disparities in HIV and other sexually transmitted infections (STIs) in the US. The purpose of this longitudinal qualitative study was to learn about the processes through which partner incarceration affects African-American women's sexual risk. Four waves of in-depth qualitative interviews were conducted in 2010-2011 with 30 women in Atlanta, Georgia (US) who had recently incarcerated partners. Approximately half the sample misused substances at baseline. Transcripts were analyzed using grounded theory. For over half the sample (N = 19), partner incarceration resulted in destitution, and half of this group (N = 9) developed new partnerships to secure shelter or food; most misused substances. Other women (N = 9) initiated casual relationships to meet emotional or sexual needs. When considered with past research, these findings suggest that reducing incarceration rates among African-American men may reduce HIV/STIs among African-American women, particularly among substance-misusing women, as might rapidly linking women with recently incarcerated partners to housing and economic support and drug treatment.

African American Women and Sexually Transmitted Infections: The Contextual Influence of Unbalanced Sex Ratios and Individual Risk Behaviors

“…In this study, 90% of women who had been diagnosed with an STI had dated a man who had been in prison or jail. This finding is consistent with current literature, which suggests that there is an elevated STI risk among African American women with male partners who have been incarcerated (Cooper et al, 2015; Khan et al, 2011; Khan et al, 2009; Swartzendruber et al, 2012). The ability to accurately measure risk behavior among incarcerated men has continuously been a challenge, particularly among African American men, who seem to be significantly less likely to report engaging in sexual behaviors with other men (Millett et al, 2012).…”

“…Lichtenstein (2000) asserts that African American men with a history of incarceration may become habituated to unprotected sex, therefore increasing the risk of contracting STIs, and subsequently transmission of STIs to African American women. This finding, with support from other scholarly works (Andraski et al, 2014; Cooper et al, 2015), suggest that racialized mass incarceration may be an important contextual determinant of sexual health in the African American community.…”

“…African American women who perceived there was a limited pool of African American male partners were not significantly more likely to report an STI history. It is plausible that while an individual’s perception about the pool of eligible African American male partners is an important consideration when examining partner selection among African American women (Andraski et al, 2014; Cooper et al, 2015), it may play a less significant role than partner characteristics when it comes to examining the correlates of STIs. In fact, two partner characteristics – which may be influenced by the social contextual factors underpinning Wilson’s (1987) Male Marriage Pool Index – were significantly associated with a lifetime STI diagnosis in the multivariate models.…”

“…Whether it is known or unknown, having concurrent sexual partners has been demonstrated to be a contributing factor to the higher prevalence of STIs in the African American community (Adimora et al, 2002; Aral, Adimora, & Fenton, 2008; Morris et al, 2009; Voisin et al, 2013). Prior research indicates African American women perceive African American men as untrustworthy and manipulative in the context of relationships (Andrasik et al, 2014) and economic aspects are oftentimes driving factors in relationships (Andrasik et al, 2014; Cooper et al, 2015). The current study lends additional support to these findings, and results in the full multivariate model indicate that – even in the presence of a variety of drug history, demographic, sexual behavior, and HIV belief measures – dating a partner who engaged in concurrent partnerships was a robust correlate of contracting an STI.…”

Dual Incarceration and Condom Use in Committed Relationships

“…The disruptions caused by the loss of a partner to incarceration can lead individuals to seek new, potentially risky partners for both economic and social support. In two qualitative studies, Megan Comfort and Hannah Cooper each qualitatively describe how incarceration shapes and constrains women’s relationships with incarcerated male partners, both during and after incarceration (11, 12), and specifically, how such experiences affect sexual behavior within the relationship. For example, partners may engage in unsafe sex following incarceration because they are trying to reconnect after separation and condom-less sex is one way of re-establishing intimacy (9).…”