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Koshenova D, Alimkkulov Y, Bisengali L, Turgumbayev M, Beaver KM. Examining the Longitudinal Connection Between Adolescent Delinquency and Risky Sexual Behaviors in a Sample of Males and Females. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2023:306624X231212814. [PMID: 38008993 DOI: 10.1177/0306624x231212814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2023]
Abstract
Adolescence is a time period that is highlighted by widespread involvement in delinquent behaviors. The long-term consequences associated with engaging in such behaviors is not entirely understood. There is some research showing, though, that adolescents who are involved in delinquency are at-risk for also engaging in an assortment of risky sexual behaviors. Whether this association is causal or the result of selection/confounding remains unclear. The current study sought to add to the literature on this topic by examining whether measures of adolescent delinquency predict later-life involvement in risky sexual behaviors (number of sexual partners, number of one-night stands, and being diagnosed with a sexually transmitted infection) in a sample from the United States. To do so, data drawn from the National Longitudinal Study of Adolescent to Adult Health (Add Health) were analyzed (N ranging from 5018 to 5964). The results revealed statistically significant associations between adolescent delinquency and risky sexual behaviors for males and females even after controlling for levels of self-control, exposure to peer substance use, parental socialization, and neighborhood disadvantage. These results suggest that the association between delinquent involvement and risky sexual behaviors is robust and future research should begin to systematically examine the developmental nature of this association.
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Affiliation(s)
| | | | | | | | - Kevin M Beaver
- Florida State University, Tallahassee, FL, USA
- King Abdulaziz University, Jeddah, Saudi Arabia
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2
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Dauria EF, Kulkarni P, Clemenzi-Allen A, Brinkley-Rubinstein L, Beckwith CG. Interventions Designed to Improve HIV Continuum of Care Outcomes for Persons with HIV in Contact with the Carceral System in the USA. Curr HIV/AIDS Rep 2022; 19:281-291. [PMID: 35674879 PMCID: PMC9175158 DOI: 10.1007/s11904-022-00609-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW To describe existing evidence and identify future directions for intervention research related to improving HIV care outcomes for persons with HIV involved in the carceral system in the USA, a population with high unmet HIV care needs. RECENT FINDINGS Few recent intervention studies focus on improving HIV care outcomes for this population. Successful strategies to improve care outcomes include patient navigation, substance use treatment, and incentivizing HIV care outcomes. Technology-supported interventions are underutilized in this population. Notable gaps in the existing literature include intervention research addressing HIV care needs for cisgender and transgender women and those under carceral supervision in the community. Future research should address existing gaps in the literature and respond to emergent needs including understanding how the changing HIV care delivery environment resulting from the COVID-19 pandemic and the approval of new injectable ART formulation shape HIV care outcomes in this population.
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Affiliation(s)
- Emily F Dauria
- Graduate School of Public Health, Department of Behavioral and Community Health Sciences, University of Pittsburgh, Pittsburgh, PA, USA.
| | - Priyanka Kulkarni
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Angelo Clemenzi-Allen
- Division of HIV, Infectious Diseases and Global Medicine, University of California, San Francisco, San Francisco, CA, USA
- San Francisco Department of Public Health, San Francisco, CA, USA
| | - Lauren Brinkley-Rubinstein
- Department of Social Medicine and Center for Health Equity Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Curt G Beckwith
- Alpert Medical School, Division of Infectious Diseases/Department of Medicine, Brown University, Providence, RI, USA
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3
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Hackett L, Biderman M, Doria N, Courville J, Bogner E, Spencer R, Miller D, McMillan J, Numer M. A rapid review of Indigenous boys' and men's sexual health in Canada. CULTURE, HEALTH & SEXUALITY 2021; 23:705-721. [PMID: 32223538 DOI: 10.1080/13691058.2020.1722856] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Accepted: 01/24/2020] [Indexed: 06/10/2023]
Abstract
Indigenous boys and men in Canada face adverse social and structural circumstances that affect their ability to achieve and maintain sexual health. Research about Indigenous sexual health, however, is largely limited to matters relating to women and statistics on sexually transmitted infections. A rapid review of research was conducted to determine what is currently known about Indigenous boys' and men's sexual health in Canada. Given the prevalence of research documenting quantitative disparities, the current review included qualitative research only. Thirteen included studies explored a wide range of topics relating to sexual health and an overarching intersection between social conditions and individual health outcomes was observed. The results of this review reveal significant gaps in the literature relating to the holistic sexual health of Indigenous boys and men and highlight important domains of sexual health to consider in future research. Findings suggest that sexual health programmes that promote traditional Indigenous knowledge and intergenerational relationships may be effective for promoting sexual health among Indigenous boys and men.
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Affiliation(s)
- Lisa Hackett
- School of Health and Human Performance, Dalhousie University, Halifax, NS, Canada
| | - Maya Biderman
- School of Health and Human Performance, Dalhousie University, Halifax, NS, Canada
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Nicole Doria
- School of Health and Human Performance, Dalhousie University, Halifax, NS, Canada
| | - Julien Courville
- School of Health and Human Performance, Dalhousie University, Halifax, NS, Canada
| | - Emma Bogner
- School of Health and Human Performance, Dalhousie University, Halifax, NS, Canada
| | - Rebecca Spencer
- School of Health and Human Performance, Dalhousie University, Halifax, NS, Canada
| | | | - Jane McMillan
- Department of Anthropology, St. Francis Xavier University, Antigonish, NS, Canada
| | - Matthew Numer
- School of Health and Human Performance, Dalhousie University, Halifax, NS, Canada
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4
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Severe M, Scheidell JD, Dyer TV, Brewer RA, Negri A, Turpin RE, Young KE, Hucks-Ortiz C, Cleland CM, Mayer KH, Khan MR. Lifetime Burden of Incarceration and Violence, Internalized Homophobia, and HIV/STI Risk Among Black Men Who Have Sex with Men in the HPTN 061 Study. AIDS Behav 2021; 25:1507-1517. [PMID: 32797357 PMCID: PMC8022355 DOI: 10.1007/s10461-020-02989-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Black men who have sex with men (BMSM) have disproportionate HIV/STI acquisition risk. Incarceration may increase exposure to violence and exacerbate psychosocial vulnerabilities, including internalized homophobia, which are associated with HIV/STI acquisition risk. Using data from HIV Prevention Trials Network 061 (N = 1553), we estimated adjusted prevalence ratios (APR) and 95% confidence intervals (CIs) for associations between lifetime burden of incarceration and HIV/STI risk outcomes. We measured associations between incarceration and HIV/STI risk outcomes with hypothesized mediators of recent violence victimization and internalized homophobia. Compared to those never incarcerated, those with 3-9 or ≥ 10 incarcerations had approximately 10% higher prevalence of multiple partnerships. Incarceration burden was associated with selling sex (1-2 incarcerations: APR: 1.52, 95% CI 1.14-2.03; 3-9: APR: 1.77, 95% CI 1.35-2.33; ≥ 10: APR: 1.85, 95% CI 1.37-2.51) and buying sex (≥ 10 incarcerations APR: 1.80, 95% CI 1.18-2.75). Compared to never incarcerated, 1-2 incarcerations appeared to be associated with current chlamydia (APR: 1.47, 95% CI 0.98-2.20) and 3-9 incarcerations appeared to be associated with current syphilis (APR: 1.46, 95% CI 0.92-2.30). Incarceration was independently associated with violence, which in turn was a correlate of transactional sex. Longitudinal research is warranted to clarify the role of incarceration in violence and HIV/STI risk in this population.
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Affiliation(s)
- MacRegga Severe
- Department of Population Health, New York University Grossman School of Medicine, 227 East 30th St, #617J, New York, NY, 10016, USA
| | - Joy D Scheidell
- Department of Population Health, New York University Grossman School of Medicine, 227 East 30th St, #617J, New York, NY, 10016, USA.
| | - Typhanye V Dyer
- Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, MD, USA
| | | | - Alberta Negri
- Department of Population Health, New York University Grossman School of Medicine, 227 East 30th St, #617J, New York, NY, 10016, USA
| | - Rodman E Turpin
- Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, MD, USA
| | - Kailyn E Young
- Department of Population Health, New York University Grossman School of Medicine, 227 East 30th St, #617J, New York, NY, 10016, USA
| | | | - Charles M Cleland
- Department of Population Health, New York University Grossman School of Medicine, 227 East 30th St, #617J, New York, NY, 10016, USA
| | | | - Maria R Khan
- Department of Population Health, New York University Grossman School of Medicine, 227 East 30th St, #617J, New York, NY, 10016, USA
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5
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Marotta PL, Gilbert L, Goddard-Eckrich D, Hunt T, Metsch L, Davis A, Feaster D, Wu E, El-Bassel N. A Dyadic Analysis of Criminal Justice Involvement and Sexual HIV Risk Behaviors Among Drug-Involved Men in Community Corrections and Their Intimate Partners in New York City: Implications for Prevention, Treatment and Policies. AIDS Behav 2021; 25:1047-1062. [PMID: 33057892 PMCID: PMC8570384 DOI: 10.1007/s10461-020-03019-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Indexed: 10/23/2022]
Abstract
People in community corrections have rates of HIV and sexual risk behaviors that are much higher than the general population. Prior literature suggests that criminal justice involvement is associated with increased sexual risk behaviors, yet these studies focus on incarceration and use one-sided study designs that only collect data from one partner. To address gaps in the literature, this study used the Actor Partner-Interdependence Model with Structural Equation Modeling (SEM), to perform a dyadic analysis estimating individual (actor-only) partner-only, and dyadic patterns (actor-partner) of criminal justice involvement and greater sexual risks in a sample of 227 men on probation and their intimate partners in New York City, United States. Standard errors were bootstrapped with 10,000 replications to reduce bias in the significance tests. Goodness of fit indices suggested adequate or better model fit for all the models. Significant actor-only relationships included associations between exposures to arrest, misdemeanor convictions, time spent in jail or prison, felony convictions, lifetime number of incarceration events, prior conviction for disorderly conduct and increased sexual risk behaviors. Partner only effects included significant associations between male partners conviction for a violent crime and their female partners' sexual risk behaviors. Men's encounters with police and number of prior misdemeanors were associated with their own and intimate partners' sexual risk behaviors. Women's prior arrest was associated with their own and intimate partners' sexual risk behaviors. The results from the present study suggest that men on probation and their intimate partners' criminal justice involvement are associated with increased engagement in sexual risk behaviors. It is necessary to conduct greater research into developing dyadic sexual risk reduction and HIV/STI prevention interventions for people who are involved in the criminal justice system.
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Affiliation(s)
- Phillip L Marotta
- Division of Prevention and Community Psychology, Department of Psychiatry, Yale University School of Medicine, 389 Whitney Avenue, New Haven, CT, USA.
- The Consultation Center, Yale University, New Haven, CT, USA.
| | - Louisa Gilbert
- School of Social Work, Columbia University, New York City, NY, USA
- Social Intervention Group, Columbia University, New York City, NY, USA
| | - Dawn Goddard-Eckrich
- School of Social Work, Columbia University, New York City, NY, USA
- Social Intervention Group, Columbia University, New York City, NY, USA
| | - Tim Hunt
- School of Social Work, Columbia University, New York City, NY, USA
- Social Intervention Group, Columbia University, New York City, NY, USA
| | - Lisa Metsch
- School of General Studies, Columbia University, New York City, NY, USA
- Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Alissa Davis
- School of Social Work, Columbia University, New York City, NY, USA
- Social Intervention Group, Columbia University, New York City, NY, USA
| | - Daniel Feaster
- Department of Biostatistics, School of Public Health, University of Miami, Miami, FL, USA
| | - Elwin Wu
- School of Social Work, Columbia University, New York City, NY, USA
- Social Intervention Group, Columbia University, New York City, NY, USA
| | - Nabila El-Bassel
- School of Social Work, Columbia University, New York City, NY, USA
- Social Intervention Group, Columbia University, New York City, NY, USA
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6
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Abstract
Concurrent sexual partnerships (i.e., relationships that overlap in time) contribute to higher HIV acquisition risk. Social capital, defined as resources and connections available to individuals is hypothesized to reduce sexual HIV risk behavior, including sexual concurrency. Additionally, we do not know whether any association between social capital and sexual concurrency is moderated by gender. Multivariable logistic regression tested the association between social capital and sexual concurrency and effect modification by gender. Among 1445 African Americans presenting for care at an urban STI clinic in Jackson, Mississippi, mean social capital was 2.85 (range 1-5), mean age was 25 (SD = 6), and 62% were women. Sexual concurrency in the current year was lower for women compared to men (45% vs. 55%, χ2(df = 1) = 11.07, p = .001). Higher social capital was associated with lower adjusted odds of sexual concurrency for women compared to men (adjusted Odds Ratio [aOR] = 0.62 (95% CI 0.39-0.97), p = 0.034), controlling for sociodemographic and psychosocial covariates. Interventions that add social capital components may be important for lowering sexual risk among African Americans in Mississippi.
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7
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Mahaffey CC, Stevens-Watkins D, Burlew AK, Moody MD, Wheeler PB, Thrasher S. Evaluating the Feasibility of Implementing an HIV Prevention Intervention for Incarcerated African American Men: Lessons Learned From a Pilot Study. Health Promot Pract 2020; 21:822-830. [PMID: 31958976 DOI: 10.1177/1524839919896786] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This pilot study evaluated the feasibility of implementing an evidence-based, culturally adapted HIV intervention with substance-using African American men in a prison setting. We recruited 60, soon-to-be released African American male prisoners from a larger study (N = 211) to be randomly selected for participation in the group-based HIV intervention, Real Men Are Safe-Culturally Adapted (REMAS-CA). Participants who were not selected for participation in the intervention received standard Centers for Disease Control and Prevention HIV prevention counseling education, provided during participant assessment in the larger study. Nearly all of the participants who were selected to participate (87%) completed the REMAS-CA intervention. To examine feasibility, data were collected about any revisions made to the HIV intervention components for the prison setting, time needed to implement the program in full, details of implementing the intervention to ensure participation and maintain retention, and participant perception of the intervention. Revisions to the intervention included reducing the number of sessions from five to three, modifying the protocol language based on the setting, and removing six activities deemed inappropriate and/or unallowable by the prison officials. The cultural considerations and intervention, overall, were well received by the participants. However, several revisions made specific to the prison and its administration could affect the potential effectiveness of the intervention. Future research is needed to determine the effectiveness of REMAS-CA among this community.
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Affiliation(s)
| | - Danelle Stevens-Watkins
- University of Kentucky, Lexington, KY, USA.,Center on Drug and Alcohol Research, Lexington, KY, USA
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8
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Wise A, Finlayson T, Sionean C, Paz-Bailey G. Incarceration, HIV Risk-Related Behaviors, and Partner Characteristics Among Heterosexual Men at Increased Risk of HIV Infection, 20 US Cities. Public Health Rep 2019; 134:63S-70S. [PMID: 31059417 DOI: 10.1177/0033354919833435] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES The effect of incarceration on HIV risk-related behaviors among at-risk heterosexual men is understudied. The objective of our study was to examine the association between incarceration and HIV risk-related behaviors among a sample of predominantly non-Hispanic black and Hispanic heterosexual men residing in urban areas in the United States with a high prevalence of AIDS. METHODS We analyzed data from the 2013 National HIV Behavioral Surveillance system on 5321 at-risk heterosexual men using log-linked Poisson regression models, adjusted for demographic characteristics and clustered on city. RESULTS Of 5321 men, 1417 (26.6%) had recently been incarcerated (in the past 12 months), 2781 (52.3%) had ever been incarcerated but not in the past 12 months, and 1123 (21.1%) had never been incarcerated. Recent incarceration was associated with multiple casual female sexual partners (adjusted prevalence ratio [aPR] = 1.23; 95% confidence interval [CI], 1.05-1.44), condomless sex with multiple female sexual partners (aPR = 1.32; 95% CI, 1.06-1.66), injection drug use (aPR = 3.75; 95% CI, 2.64-5.32), and having sexual partners who were more likely to have ever injected drugs (aPR = 1.84; 95% CI, 1.48-2.28), been incarcerated (aPR = 2.28; 95% CI, 2.01-2.59), or had a concurrent sexual partner (aPR = 1.08; 95% CI, 1.05-1.11), as compared with never-incarcerated men. CONCLUSIONS Incarceration history was associated with HIV risk-related behaviors among heterosexual men from urban areas in the United States. Correctional rehabilitation initiatives are needed to promote strategies that mitigate HIV risk-related behaviors and promote healthy reentry into communities among heterosexual men at high risk for HIV.
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Affiliation(s)
- Akilah Wise
- 1 Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA, USA.,2 Division of HIV/AIDS Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Teresa Finlayson
- 2 Division of HIV/AIDS Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Catlainn Sionean
- 2 Division of HIV/AIDS Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Gabriela Paz-Bailey
- 2 Division of HIV/AIDS Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
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9
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Templeton M, Kelly C, Lohan M. Developing a Sexual Health Promotion Intervention With Young Men in Prisons: A Rights-Based Participatory Approach. JMIR Res Protoc 2019; 8:e11829. [PMID: 31033447 PMCID: PMC6658311 DOI: 10.2196/11829] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 11/02/2018] [Accepted: 01/14/2019] [Indexed: 12/11/2022] Open
Abstract
Background The sexual health of young men in prisons is often among the poorest in any given country. They may have developed sexual behaviors that, from a public health perspective, are considered problematic and burdensome. These include poorer use of condoms and engaging in more frequent casual sex, resulting in higher rates of sexually transmitted infections, including HIV and viral hepatitis. Thus, young incarcerated men are a highly marginalized and socially excluded high-risk group, in greater need of sexual health education and services. Objective The aim of this study was to create an innovative sexual health promotion intervention, made for and with young men in prisons, to encourage them to avail of regular sexual health checkups. This included developing a Web-based animated-style sexual health promotion intervention (1.42 min) coupled with upskilling the prison nurses to offer a partnership approach to prison health care. This paper focuses on the development of the intervention and the importance of the underpinning rights-based (RB) participatory intervention design. Methods We employed an RB participatory approach and recruited 14 participants who attended 3 coproduction workshops held within a prison site in Northern Ireland, United Kingdom. A bespoke 3-day training for nurses beforehand, ensured they gained a deeper understanding of the determinants of poor sexual health. The coproduction team comprised young men, prison nurses, nurse sexual health consultant, media company representatives, and facilitator. Workshops focused on content, design, tone and medium of communication for a Web-based intervention that would be appealing and engaging for young incarcerated men. Results A 1.42-min animation Dick loves Doot was created to promote a positive attitude toward sexual health checkups. The RB approach enabled the young men to participate, have their voices heard and see their stories reflected through the animation. The nurses’ capacities to protect, fulfill, and respect the young men’s rights to appropriate sexual health services and education was also enhanced. Evaluations confirmed that we successfully provided accurate sexual health information in a way that was engaging and accessible and that encouraged the young men to avail of the new prison sexual health services that were set up in the prison and now provided by nurses. Conclusions The RB participatory approach to health advanced in this study provided a means to (1) gain invaluable insider knowledge to understand the impact of structural determinants on health and health inequalities and strategies by which to target young incarcerated men (2) create inclusive opportunities for developing bespoke targeted interventions, and (3) galvanize collaborative partnerships to disrupt the structures and processes that lead to and encourage health inequities. To reduce future risk, effective treatment, coupled with coproduced interventions that transmit relevant health messages in a relevant and meaningful way, is key to success.
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Affiliation(s)
- Michelle Templeton
- Queen's University Belfast, School of Nursing and Midwifery, Belfast, United Kingdom
| | - Carmel Kelly
- Queen's University Belfast, School of Nursing and Midwifery, Belfast, United Kingdom
| | - Maria Lohan
- Queen's University Belfast, School of Nursing and Midwifery, Belfast, United Kingdom
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10
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McCree DH, Beer L, Prather C, Gant Z, Harris N, Sutton M, Sionean C, Dunbar E, Smith J, Wortley P. An Approach to Achieving the Health Equity Goals of the National HIV/AIDS Strategy for the United States Among Racial/Ethnic Minority Communities. Public Health Rep 2018; 131:526-30. [PMID: 27453595 DOI: 10.1177/0033354916662209] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Donna Hubbard McCree
- Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Division of HIV/AIDS Prevention, Atlanta, GA
| | - Linda Beer
- Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Division of HIV/AIDS Prevention, Atlanta, GA
| | - Cynthia Prather
- Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Division of HIV/AIDS Prevention, Atlanta, GA
| | - Zanetta Gant
- Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Division of HIV/AIDS Prevention, Atlanta, GA
| | - Norma Harris
- Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Division of HIV/AIDS Prevention, Atlanta, GA
| | - Madeline Sutton
- Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Division of HIV/AIDS Prevention, Atlanta, GA
| | - Catlainn Sionean
- Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Division of HIV/AIDS Prevention, Atlanta, GA
| | - Erica Dunbar
- Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Division of HIV/AIDS Prevention, Atlanta, GA
| | - Jennifer Smith
- Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Division of HIV/AIDS Prevention, Atlanta, GA
| | - Pascale Wortley
- Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Division of HIV/AIDS Prevention, Atlanta, GA
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11
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Fields JC, King KM, Alexander KA, Smith KC, Sherman SG, Knowlton A. Recently released Black men's perceptions of the impact of incarceration on sexual partnering. CULTURE, HEALTH & SEXUALITY 2018; 20:55-68. [PMID: 28532296 DOI: 10.1080/13691058.2017.1325009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Evidence suggests that men with recent histories of incarceration are more likely to engage in high-risk sexual activity, however there is limited research exploring how having been recently released from prison might impact men's sexual risk behaviours or sexual partnering. This qualitative study explores the ways in which exposure to incarceration impacts the dynamics of sexual partnering among recently released Black men in Baltimore, USA. In-depth interviews were conducted with 19 recently released Black men between 21-45 years of age living in the city. Data were analysed using a combination of inductive and deductive approaches. Participants reported that women living in the neighbourhoods to which they returned found recently released men to be highly desirable sexual partners because they offered increased potential for sexual gratification, were perceived as healthier than other sexual partners in their communities and represented opportunities for attaining financial stability and the potential for establishing romantic partnerships. As a result, men reported they had more opportunities for sex and more power to negotiate sex with women. Recently released Black men's perceptions of their own sexual desirability among women raise important implications regarding power in the sexual relationships of recently released men that may increase HIV- and sexually transmitted infection-related risk for recently released men and their sexual partners.
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Affiliation(s)
- Julie C Fields
- a Department of Health, Behaviour and Society , Johns Hopkins Bloomberg School of Public Health , Baltimore , USA
| | - Kelly M King
- b Department of Epidemiology , Johns Hopkins Bloomberg School of Public Health , Baltimore , USA
| | - Kamila A Alexander
- c School of Nursing , Johns Hopkins Bloomberg School of Public Health , Baltimore , USA
| | - Katherine C Smith
- a Department of Health, Behaviour and Society , Johns Hopkins Bloomberg School of Public Health , Baltimore , USA
| | - Susan G Sherman
- a Department of Health, Behaviour and Society , Johns Hopkins Bloomberg School of Public Health , Baltimore , USA
| | - Amy Knowlton
- a Department of Health, Behaviour and Society , Johns Hopkins Bloomberg School of Public Health , Baltimore , USA
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12
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Pouget ER. Social determinants of adult sex ratios and racial/ethnic disparities in transmission of HIV and other sexually transmitted infections in the USA. Philos Trans R Soc Lond B Biol Sci 2017; 372:20160323. [PMID: 28760764 PMCID: PMC5540863 DOI: 10.1098/rstb.2016.0323] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2017] [Indexed: 11/12/2022] Open
Abstract
In Black population centres in the USA, adult sex ratios (ASRs) are strongly female-biased primarily due to high male incarceration and early mortality rates. I explore the system of social determinants that shape these ASRs, and describe their apparent consequences. Evidence suggests that female-biased ASRs play a role, along with racial residential segregation, to increase mixing between core and peripheral members of sexual networks, facilitating transmission of human immunodeficiency virus and other sexually transmitted infections. Unique historical factors underlie Black male incarceration and mortality rates in the USA, making comparisons with other groups or other countries challenging.This article is part of the themed issue 'Adult sex ratios and reproductive decisions: a critical re-examination of sex differences in human and animal societies'.
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Affiliation(s)
- Enrique Rodriguez Pouget
- Center for Policing Equity at John Jay College of Criminal Justice, 524 West 59th Street, Room 6.63.14, New York, NY 10019, USA
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13
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Abram KM, Stokes ML, Welty LJ, Aaby DA, Teplin LA. Disparities in HIV/AIDS Risk Behaviors After Youth Leave Detention: A 14-Year Longitudinal Study. Pediatrics 2017; 139:e20160360. [PMID: 28115541 PMCID: PMC5260145 DOI: 10.1542/peds.2016-0360] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/14/2016] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To examine changes in the prevalence of 15 HIV/AIDS sex and drug risk behaviors in delinquent youth during the 14 years after they leave detention, focusing on sex and racial/ethnic differences. METHODS The Northwestern Juvenile Project, a prospective longitudinal study of 1829 youth randomly sampled from detention in Chicago, Illinois, recruited between 1995 and 1998 and reinterviewed up to 11 times. Independent interviewers assessed HIV/AIDS risk behaviors using the National Institutes on Drug Abuse Risk Behavior Assessment. RESULTS Fourteen years after detention (median age, 30 years), one-quarter of males and one-tenth of females had >1 sexual partner in the past 3 months. One-tenth of participants reported recent unprotected vaginal sex with a high-risk partner. There were many sex and racial/ethnic differences. For example, African American males had 4.67 times the odds of having >1 partner than African American females (95% confidence interval [CI], 3.22-6.76). Over time, compared with non-Hispanic white males, African American males had 2.56 times the odds (95% CI, 1.97-3.33) and Hispanic males had 1.63 times the odds (95% CI, 1.24-2.12) of having multiple partners, even after adjusting for incarceration and age. Non-Hispanic white females were more likely to have multiple partners than racial/ethnic minority females. CONCLUSIONS Although rates decrease over time, prevalence of sex risk behaviors are much higher than the general population. Among males, racial/ethnic minorities were at particular risk. The challenge for pediatric health is to address how disproportionate confinement of racial/ethnic minority youth contributes to disparities in the HIV/AIDS epidemic.
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Affiliation(s)
- Karen M Abram
- Departments of Psychiatry and Behavioral Sciences, and
| | | | - Leah J Welty
- Departments of Psychiatry and Behavioral Sciences, and
- Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - David A Aaby
- Departments of Psychiatry and Behavioral Sciences, and
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Rojas P, Huang H, Li T, Ravelo GJ, Sanchez M, Dawson C, Brook J, Kanamori M, De La Rosa M. Sociocultural Determinants of Risky Sexual Behaviors among Adult Latinas: A Longitudinal Study of a Community-Based Sample. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:E1164. [PMID: 27886095 PMCID: PMC5129374 DOI: 10.3390/ijerph13111164] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Revised: 11/11/2016] [Accepted: 11/15/2016] [Indexed: 11/29/2022]
Abstract
Few studies have examined the sociocultural determinants of risky sexual behavior trajectories among adult Latinas. To longitudinally examine the link between sociocultural determinants of risky sexual behaviors, we followed a sample of adult Latina mother-daughter dyads (n = 267) across a 10-year span through four waves of data collection. The present study investigates how risky sexual behavior (operationalized as sex under the influence of alcohol or other drugs, sex without a condom, or multiple sex partners) is affected by: (a) socioeconomic conditions; (b) mental health; (c) medical health; (d) acculturation to U.S. culture; (e) interpersonal support; (f) relationship stress; (g) mother-daughter attachment; (h) intimate partner violence; (i) religious involvement; and (j) criminal justice involvement. Results indicate the following factors are negatively associated with risky sexual behavior: drug and alcohol use, treating a physical problem with prescription drugs, religious involvement, and mother-daughter attachment. The following factors are positively associated with risky sexual behavior: higher number of mental health symptoms, being U.S.-born, and criminal justice involvement. We discuss implications for the future development of culturally relevant interventions based on the study findings.
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Affiliation(s)
- Patria Rojas
- Center for Research on U.S. Latino HIV/AIDS and Drug Abuse, Florida International University, Miami, FL 33199, USA.
- Department of Health Promotion and Disease Prevention, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL 33199, USA.
| | - Hui Huang
- Center for Research on U.S. Latino HIV/AIDS and Drug Abuse, Florida International University, Miami, FL 33199, USA.
- Department of Health Promotion and Disease Prevention, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL 33199, USA.
| | - Tan Li
- Center for Research on U.S. Latino HIV/AIDS and Drug Abuse, Florida International University, Miami, FL 33199, USA.
- Department of Biostatistics, School of Public Health, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL 33199, USA.
| | - Gira J Ravelo
- Center for Research on U.S. Latino HIV/AIDS and Drug Abuse, Florida International University, Miami, FL 33199, USA.
- School of Social Work, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL 33199, USA.
| | - Mariana Sanchez
- Center for Research on U.S. Latino HIV/AIDS and Drug Abuse, Florida International University, Miami, FL 33199, USA.
- School of Social Work, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL 33199, USA.
| | - Christyl Dawson
- Center for Research on U.S. Latino HIV/AIDS and Drug Abuse, Florida International University, Miami, FL 33199, USA.
- School of Social Work, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL 33199, USA.
| | - Judith Brook
- New York University School of Medicine, New York University, 215 Lexington Avenue, New York, NY 10017, USA.
| | - Mariano Kanamori
- Center for Research on U.S. Latino HIV/AIDS and Drug Abuse, Florida International University, Miami, FL 33199, USA.
- School of Social Work, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL 33199, USA.
| | - Mario De La Rosa
- Center for Research on U.S. Latino HIV/AIDS and Drug Abuse, Florida International University, Miami, FL 33199, USA.
- School of Social Work, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL 33199, USA.
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Stigma, sexual risks, and the war on drugs: Examining drug policy and HIV/AIDS inequities among African Americans using the Drug War HIV/AIDS Inequities Model. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2016; 37:31-41. [PMID: 27565526 DOI: 10.1016/j.drugpo.2016.07.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 06/27/2016] [Accepted: 07/21/2016] [Indexed: 11/23/2022]
Abstract
The relationship between drug policy and HIV vulnerability is well documented. However, little research examines the links between racial/ethnic HIV disparities via the Drug War, sexual risk, and stigma. The Drug War HIV/AIDS Inequities Model has been developed to address this dearth. This model contends that inequitable policing and sentencing promotes sexual risks, resource deprivation, and ultimately greater HIV risk for African-Americans. The Drug War also socially marginalizes African Americans and compounds stigma for incarcerated and formerly incarcerated persons living with HIV/AIDS. This marginalization has implications for sexual risk-taking, access to health-promoting resources, and continuum of care participation. The Drug War HIV/AIDS Inequities Model may help illuminate mechanisms that promote increased HIV vulnerability as well as inform structural intervention development and targeting to address racial/ethnic disparities.
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Spohr SA, Suzuki S, Marshall B, Taxman FS, Walters ST. Social support quality and availability affects risk behaviors in offenders. HEALTH & JUSTICE 2016; 4:2. [PMID: 27054059 PMCID: PMC4766225 DOI: 10.1186/s40352-016-0033-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Accepted: 02/10/2016] [Indexed: 06/01/2023]
Abstract
BACKGROUND People involved in the justice system are at 2.5 times the risk of HIV infection compared to the general population, which is further complicated by substance abuse. The purpose of this study was to evaluate the role of social network quality and quantity on unprotected sex, criminal risk, and substance use. METHODS We used data from 330 drug-involved offenders. Structural equation modeling (SEM) was used to model and test path directionality and magnitude between the latent constructs of social support quality and quantity on risky behaviors. RESULTS The SEM indicated the latent construct of social support quality was significantly associated with reduced sexual risk behavior (β = -0.27), criminal risk (β = -0.26), and reduced substance use (β = -0.33). Additionally, the proposed model found that social support quantity was significantly positively associated with increased sexual risk behavior (β = 0.40) and substance use (β = 0.20). CONCLUSIONS Social support quality is an important predictor of risky behaviors; as the quality of an offender's social support increases, engagement in risky behaviors decreases. Probationers who had broader social support availability also had increased substance use and unprotected sex. Probation systems may be able to reduce substance use and STD/HIV infection risk in offenders by strengthening the quality of social support networks.
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Affiliation(s)
| | - Sumihiro Suzuki
- University of North Texas Health Science Center, Fort Worth, USA
| | | | | | - Scott T Walters
- University of North Texas Health Science Center, Fort Worth, USA
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17
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Knittel AK, Snow RC, Riolo RL, Griffith DM, Morenoff J. Modeling the community-level effects of male incarceration on the sexual partnerships of men and women. Soc Sci Med 2015; 147:270-9. [PMID: 26610077 PMCID: PMC4691451 DOI: 10.1016/j.socscimed.2015.11.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Revised: 10/23/2015] [Accepted: 11/05/2015] [Indexed: 11/24/2022]
Abstract
Men who have been incarcerated experience substantial changes in their sexual behavior after release from jail and prison, and high rates of incarceration may change sexual relationship patterns at a community level. Few studies, however, address how rates of incarceration affect community patterns of sexual behavior, and the implications of those patterns for HIV and STD risk. We describe a "proof of principle" computational model that tests whether rates of male incarceration could, in part, explain observed population-level differences in patterns of sexual behavior between communities with high rates of incarceration and those without. This validated agent-based model of sexual partnership among 20-25 year old heterosexual urban residents in the United States uses an algorithm that incarcerates male agents and then releases them back into the agent community. The results from these model experiments suggest that at rates of incarceration similar to those observed for urban African American men, incarceration can cause an increase in the number of partners at the community level. The results suggest that reducing incarceration and creating a more open criminal justice system that supports the maintenance of inmates' relationships to reduce instability of partnerships for men who are incarcerated may have important sexual health and public health implications. Incarceration is one of many social forces that affect sexual decision-making, and incarceration rates may have substantial effects on community-level HIV and STD risks.
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Affiliation(s)
- Andrea K Knittel
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, USA; University of Michigan Medical School, 1137 Catherine Street, Ann Arbor, MI 48109, USA.
| | - Rachel C Snow
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, USA.
| | - Rick L Riolo
- Center for the Study of Complex Systems, University of Michigan, 1085 S. University Ave., Ann Arbor, MI 48109, USA.
| | - Derek M Griffith
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, USA.
| | - Jeffrey Morenoff
- Department of Sociology, University of Michigan, 500 S State St #3001, Ann Arbor, MI 48109, USA.
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18
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Dauria EF, Oakley L, Jacob Arriola K, Elifson K, Wingood G, Cooper HLF. Collateral consequences: implications of male incarceration rates, imbalanced sex ratios and partner availability for heterosexual Black women. CULTURE, HEALTH & SEXUALITY 2015; 17:1190-206. [PMID: 26056724 PMCID: PMC4578986 DOI: 10.1080/13691058.2015.1045035] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
While studies have found correlations between rates of incarceration and sexually transmitted infections (STIs), few studies have explored the mechanisms linking these phenomena. This qualitative study examines how male incarceration rates and sex ratios influence perceived partner availability and sexual partnerships for heterosexual Black women. Semi-structured interviews were conducted with 33 Black women living in two US neighbourhoods, one with a high male incarceration rate and an imbalanced sex ratio (referred to as 'Allentown') and one with a low male incarceration rate and an equitable sex ratio (referred to as 'Blackrock'). Data were analysed using grounded theory. In Allentown, male incarceration reduced the number of available men, and participants largely viewed men available for partnerships as being of an undesirable quality. The number and desirability of men impacted on the nature of partnerships such that they were shorter, focused on sexual activity and may be with higher-risk sexual partners (e.g. transactional sex partners). In Blackrock, marriage rates contributed to the shortage of desirable male partners. By highlighting the role that the quantity and quality of male partners has on shaping sexual partnerships, this study advances current understandings of how incarceration and sex ratios shape HIV- and STI-related risk.
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Affiliation(s)
- Emily F. Dauria
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, USA
| | - Lisa Oakley
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, USA
| | - Kimberly Jacob Arriola
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, USA
| | - Kirk Elifson
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, USA
| | - Gina Wingood
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, USA
| | - Hannah L. F. Cooper
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, USA
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19
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Zhu GA, Birnbaum N, Carroll-Scott A, Evans L, Fiellin LE, Wang EA. Gender differences in HIV risk behaviors in individuals recently released from prison: results of a pilot study. HEALTH & JUSTICE 2015; 3:6. [PMCID: PMC5151802 DOI: 10.1186/s40352-014-0014-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Accepted: 12/10/2014] [Indexed: 05/27/2023]
Abstract
Background Individuals recently released from prison engage in risky behaviors that predispose them to contracting HIV. Women may be at increased risk in the immediate period post-release, given higher rates of poverty, food insecurity, and substance dependence and lower educational attainment compared with men. Methods We describe gender differences in HIV risk behaviors using validated measures and assess potential mediators of this relationship using data from a cross-sectional study of 109 individuals recently released from prison. Results Women had higher rates of HIV drug-related risk behaviors compared with men (mean score 2.72 vs. 0.068; p = .003) and HIV sex-related risk behaviors (mean score 4.32 vs. 2.31; p = .016). Women also had higher mean incomes and severity of drug and alcohol use compared with men, but equally high rates of food insecurity and low levels of AIDS knowledge. In multivariate analysis, the relationship between gender and HIV drug-related and sex-related risk behaviors was attenuated by a greater monthly income ([drug] adjusted β 0.82, 95% CI -1.02 – 2.66, p = 0.38; [sex] adjusted β 0.75, 95% CI -1.04 – 2.54, p = 0.41), as well as severity of drug use ([drug] adjusted β 0.79, 95% CI -0.55 – 2.13, p = 0.24; [sex] adjusted β 0.09, 95% CI -1.17 – 1.35, p = 0.89). Conclusions Women had higher rates of HIV risk behaviors compared with men post-release. Gender specific interventions may be useful in reducing risky drug-related and sex-related behaviors in the period immediately following release.
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Affiliation(s)
- Gefei A Zhu
- Stanford University School of Medicine, 291 Campus Dr., Stanford, CA 94305 USA
| | - Nathan Birnbaum
- Department of Internal Medicine, Yale University School of Medicine, 367 Cedar St. Harkness Building A, Ste 304, New Haven, CT 06510 USA
| | - Amy Carroll-Scott
- Drexel University School of Public Health, Nesbitt Hall, 3215 Market St., Philadelphia, PA 19104 USA
| | - Linda Evans
- All of Us or None, 1904 Franklin St., Oakland, CA 94612 USA
| | - Lynn E Fiellin
- Department of Internal Medicine, Yale University School of Medicine, 333 Cedar St., PO BOX 208056, New Haven, CT 06520-8056 USA
| | - Emily A Wang
- Department of Internal Medicine, Yale University School of Medicine, 367 Cedar St Harkness Building A, New Haven, CT 06510 USA
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20
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Ricks JM, Crosby RA, Terrell I. Elevated sexual risk behaviors among postincarcerated young African American males in the South. Am J Mens Health 2015; 9:132-8. [PMID: 24794821 PMCID: PMC4216768 DOI: 10.1177/1557988314532680] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The dramatic racial disparities in the rates of HIV/STIs(sexually transmitted infections) among African Americans make understanding broader structural factors that increase the risk for HIV/STIs crucial. The current study of young 564 African American men attending STI clinics investigated whether those who had ever been incarcerated reported recent sexual behaviors relatively more risky than their counterparts who had never been incarcerated. Participants were recruited from clinics treating STIs in three southern U.S. cities. Males 15 to 23 years of age who identified as Black/African American and reported recent (past 2 months) sexual activity were eligible. Linear mixed-effects models and generalized estimating equation models were used to assess associations between baseline incarceration history and sexual risk behavior over a 6-month follow-up period. Mean age was 19.6 years (SD = 1.87). At baseline, 240 (42.6%) men reported history of incarceration. Incarceration history predicted several risk behaviors over a 6-month follow-up period. Compared with those with no incarceration history, men previously incarcerated reported a desire to conceive a pregnancy (β = .40, p = .02), were less likely to have used a condom at last sex act (odds ratio = .91, p = .02) and were more likely to have used drugs and alcohol before sex in the past 2 months (β = .69, p < .001; β = .41, p < .001). A history of incarceration may influence the sexual risk behavior of young African American males. Prevention programs and interventions should intensify support for postincarceration African American males to help mitigate this behavior.
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Affiliation(s)
- JaNelle M Ricks
- Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Richard A Crosby
- University of Kentucky, College of Public Health, Lexington, KY, USA The Kinsey Institute for Research in Sex, Gender, and Reproduction, Bloomington, IN, USA
| | - Ivy Terrell
- Louisiana State University Health Sciences Center, New Orleans, LA, USA
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21
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Majer JM, Komer AC, Jason LA. Psychiatric severity and HIV-risk sexual behaviors among persons with substance use disorders. J Dual Diagn 2015; 11:3-11. [PMID: 25455334 PMCID: PMC4326544 DOI: 10.1080/15504263.2014.990802] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVE The relationship between mental illness and human-immunodeficiency virus (HIV)-risk sexual behavior among persons with substance use disorders is not well-established because of differences in assessing psychiatric factors (types, symptoms, severity), substance use (diagnosis, survey responses, past substance use), and HIV-risk sexual behaviors (individual measures, combination of sex/drug use risk behaviors) across studies. This study utilized a more global and dimensional aspect of psychiatric issues (problem severity) to examine the relationship with HIV-risk sexual behaviors and substance use among persons with substance use disorders. METHODS Participants included 224 men and 46 women, with a mean age of 40.4 years (SD = 9.5). The most common substances were heroin/opiates, with 41.4% reporting use of these substances (n = 110), while 27.8% reported using cocaine (n = 74) and 12.8% reported using alcohol (n = 34). Of all participants, 39 (14.4%) were identified as having high psychiatric severity (defined using the psychiatric severity score from the Addiction Severity Index), which was used as an indication of probable comorbid psychiatric and substance use disorders. Among these participants likely to have comorbid disorders, hierarchical linear regression was conducted to examine HIV-risk sexual behaviors (number of partners and unprotected sexual behaviors in the past 30 days) in relation to psychiatric severity, substance use, and gender. RESULTS Gender (women) and psychiatric severity (higher) were significantly related to greater HIV-risk sexual behaviors. After entering gender and substance use into the regression model, psychiatric severity accounted for another 21.9% of the variance in number of partners and 14.1% of the variance in unprotected sexual behaviors. Overall, the models accounted for 55.5% and 15.6% of the variance, respectively. A significant interaction was found for number of partners (but not frequency of unprotected behavior), such that those higher in psychiatric severity and higher in substance use had a greater number of sexual partners. The model including this interaction term accounted for 63.4% of the variance in number of partners. CONCLUSIONS Findings suggest psychiatric severity is an underlying risk factor for HIV-risk sexual behavior among persons with substance use disorders who have various psychiatric comorbidities.
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Affiliation(s)
- John M Majer
- a Social Sciences Department, Harry S. Truman College , Chicago , Illinois , USA
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22
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Majer JM, Glantsman O, Palmer JS, Jason LA. Predictors of Abstinence Self-Efficacy: Examining the role of HIV-risk Sexual Behavior. JOURNAL OF SOCIAL SERVICE RESEARCH 2014; 41:39-48. [PMID: 27226672 PMCID: PMC4876641 DOI: 10.1080/01488376.2014.935559] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Abstinence self-efficacy, or the confidence in ones' beliefs in one's ability to effectively engage in behaviors to maintain substance use abstinence, is a crucial recovery resource. However, little research has been conducted on what predicts increases in this recovery resource. Understanding predictors of abstinence self-efficacy could help social service practitioners in creating effective treatment plans/interventions while extending what is presently known in this small body of research. Predictors of abstinence self-efficacy were analyzed among a sample of ex-offenders (224 men and 46 women) who were completing inpatient treatment for substance use disorders. Hierarchical linear regression was conducted to examine changes in participants' abstinence self-efficacy in relation to factors directly related (HIV-risk drug use behaviors, substance use, 12-step meeting attendance) and indirectly related (HIV-risk sexual behaviors, incarceration histories) to substance use. HIV-risk sexual behaviors and substance use predicted significant decreases in abstinence self-efficacy whereas 12-step meeting attendance predicted significant increases. However, incarceration histories and HIV-risk drug use behaviors were not significant predictors of abstinence self-efficacy. Findings suggest HIV-risk sexual behavior should be considered when assessing relapse prevention for persons with substance use disorders, and that researchers should examine behaviors that are not directly related to substance use when investigating recovery resources.
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Affiliation(s)
- John M. Majer
- Social Sciences Department, Harry S. Truman College, 1145 W. Wilson Ave., Chicago IL, 60640, USA
| | - Olya Glantsman
- Center for Community Research, DePaul University, 990 W. Fullerton Ave., Chicago, IL 60640 USA
| | - John S. Palmer
- Center for Community Research, DePaul University, 990 W. Fullerton Ave., Chicago, IL 60640 USA
| | - Leonard A. Jason
- Center for Community Research, DePaul University, 990 W. Fullerton Ave., Chicago, IL 60640 USA
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Majer JM, Rodriguez J, Bloomer C, Jason LA. Predictors of HIV-risk sexual behavior: examining lifetime sexual and physical abuse histories in relation to substance use and psychiatric problem severity among ex-offenders. J Am Psychiatr Nurses Assoc 2014; 20:138-46. [PMID: 24717831 PMCID: PMC4307926 DOI: 10.1177/1078390314527552] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Lifetime histories of sexual and physical abuse have been associated with increased HIV-risk sexual behavior, and some studies have identified other variables associated with these relationships. However, there is a dearth of literature that has critically examined abuse histories and HIV-risk sexual behavior in relation to these other variables. OBJECTIVES Predictors of HIV-risk sexual behavior were analyzed among a sample of ex-offenders who were completing inpatient substance dependence treatment to identify factors related to increases in HIV-risk sexual behavior beyond that of abuse histories. DESIGN Hierarchical linear regression was conducted to examine sociodemographic characteristics, recent substance use, and current psychiatric problem severity in addition to lifetime histories of sexual/physical abuse in a cross-sectional design. RESULTS Gender, substance use, and psychiatric problem severity predicted increases in HIV-risk sexual behavior beyond what was predicted by abuse histories. Proportionately more women than men reported abuse histories. In addition, significantly more unprotected sexual than safer sexual practices were observed, but differences in these practices based on lifetime abuse histories and gender were not significant. CONCLUSIONS Findings suggest recent substance use and current psychiatric problem severity are greater risk factors for HIV-risk sexual behavior than lifetime abuse histories among persons who have substance use disorders.
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Affiliation(s)
- John M Majer
- John M. Majer, PhD, Harry S. Truman College, Chicago, IL, USA
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