Predictors of sexual behaviour among men and women in New York City area prisons

Abstract

The USA currently has the highest incarceration rate in the world. Individuals at greatest risk for HIV also tend to be among those at an elevated risk for incarceration. The HIV epidemic is driven by injection drug use and sexual behaviour, and estimates of prison-based sexual behaviour vary widely. This study examined sexual behaviour among 1,369 incarcerated men and women in the New York City area. Approximately 13 percent of the sample (n=176) reported being sexually active while incarcerated over the previous 6 months. Multiple logistic regression models were used to examine the predictors of prison sexual behaviour. The following variables were associated with increased odds of sexual activity within the previous six months: female gender (OR= 3.28; 95%CI=1.95,5.51), Black race (OR= 2.26; 95%CI=1.47,3.46), history of drug use (OR=1.85; 95% CI=1.04,3.30), bisexual (OR= 3.19; 95%CI=1.90,5.38) or homosexual identity (OR=8.50; 95% CI=3.92,18.43), and conjugal visitation programme participation (OR=66.26; 95%CI=31.42,139.74). Educational programmes regarding sexually transmitted infections and appropriate harm reduction measures are warranted for this population. The expansion of conjugal visitation programmes may also be useful in helping prisoners sustain their relationships with partners from their community and reduce the risk of infectious disease transmission in this environment.

Demographic and spatial disparity in HIV prevalence among incarcerated population in the US: A state-level analysis

“…15 According to previous studies, women have more physical vulnerability to HIV and were at least twice as likely as men to contract HIV through sex. 16 Many of the women at highest risk for HIV infection are unaware of their risk, have little or no access to HIV prevention, and are afraid, for fear of violence, to ask their partners to use condoms. 13 The overall HIV infection rate has dropped from 2000 to 2010.…”

“…It was evident from some previous studies that out of all individuals diagnosed with HIV among the incarcerated population, a significant proportion got infected due to prison-based risky sexual behavior. 10,16,21,22 Voluntary and forced (prison rape) sexual behaviors, unregulated tattooing, and injection drug use led to a high risk of transmitting and contracting HIV infections. 20 Therefore, mandatory HIV screening at intake solely is not enough to detect the population getting infected during incarceration.…”

Social representations of imprisoned women on Acquired Immunodeficiency Syndrome

“…A study of 1,369 men and women incarcerated in New York City identified that a significant proportion of the prisoners were sexually active and that most of them were not in the marital visitation program. This refers to the presence of sexual relationships within the prison environment, which occurred without the use of condoms, since they were not available to the prison population (10) .…”

“…Given this scenario, knowledge about HIV and AIDS is referred to in the literature as an important tool for adopting self-care practices (6,9) , favoring prevention and reduction of risk behavior (10) , above all, in the prison population, whose deprivation of liberty reinforces the precariousness and fragility of the guarantee of sexual rights, due to the bureaucratic and structural limitations existing in the prison establishment (7)(8) .…”

“…The evidence of gaps in the knowledge of women deprived of their freedom in relation to AIDS encourages research that addresses dimensions related to the association between infection and imprisonment. Among the many dimensions, there is highlight to the identification of social representations about AIDS (6) , the guarantee of sexual and reproductive rights of these women (8) , the analysis of individual, sexual, social and contextual conditions that contribute to the adoption of HIV risk behaviors (9)(10) , among other aspects, both nationally and internationally.…”