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Remch M, Scheidell JD, Cleland CM, Turpin R, Duncan DT, Dyer TT, Kaufman JS, Mazumdar M, Brewer R, Feelemyer J, Mayer KH, Khan MR. Mediation of the Effect of Incarceration on Selling Sex Among Black Sexual Minority Men and Black Transgender Women in the HPTN 061 Study. AIDS Behav 2023; 27:2791-2802. [PMID: 36746876 DOI: 10.1007/s10461-023-04003-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2023] [Indexed: 02/08/2023]
Abstract
Incarceration among Black sexual minority men and Black transgender women (BSMM/BTW) is disproportionately high in the United States. Limited research has documented the disruptive effect of incarceration on sexual networks and sexual partnership exchange among BSMM/BTW. We estimate the influence of incarceration on selling sex and mediating pathways among 1169 BSMM/BTW enrolled in the HIV Prevention Trials Network (HPTN) 061 cohort to assess this relationship. Mediators investigated were social support, violence, illicit drug use, and distress due to experienced racism and homophobia. During the 6 months following baseline, 14% of the cohort was incarcerated, including 24% of BTW. After adjustment, recent incarceration was associated with 1.57 (95% CI 1.02, 2.42) times the risk of subsequently selling sex. The hypothesized mediators together explained 25% of the relationship, with an indirect effect risk ratio of 1.09 (95% CI 0.97, 1.24). Our results document an association and call for more research investigating mechanisms.
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Affiliation(s)
- Molly Remch
- Department of Epidemiology, University of North Carolina at Chapel Hill Gillings School of Global Public Health, CB 7435, McGavran-Greenberg Hall, Chapel Hill, NC, 27599, USA.
| | - Joy D Scheidell
- Department of Health Sciences, University of Central Florida, Orlando, FL, USA
| | - Charles M Cleland
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Rodman Turpin
- Department of Global and Community Health, George Mason University College of Public Health, Fairfax, VA, USA
| | - Dustin T Duncan
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Typhanye T Dyer
- Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, MD, USA
| | - Jay S Kaufman
- Department of Epidemiology, Biostatistics, & Occupational Health, McGill University, Montreal, QC, Canada
| | - Medha Mazumdar
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Russell Brewer
- Department of Medicine, University of Chicago, Chicago, IL, USA
| | - Jonathan Feelemyer
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Kenneth H Mayer
- Fenway Institute, Fenway Health, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Maria R Khan
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
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Delaney DJ, Stein LAR, Bassett SS, Clarke JG. Motivational interviewing for family planning and reducing risky sexual behavior among incarcerated men nearing release: A randomized controlled pilot study. Psychol Serv 2023; 20:538-552. [PMID: 34735198 PMCID: PMC10354667 DOI: 10.1037/ser0000552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Incarcerated men are at high risk for sexually transmitted infections (STIs) and unintended partner pregnancy postrelease. Limited research has been invested in developing and testing treatments targeting risky sexual behavior and unwanted pregnancy for this at-risk population. Motivational interviewing (MI) is a promising behavioral intervention for decreasing risky sexual behaviors. This study assessed the feasibility and acceptability of MI for family planning and risky sexual behaviors with incarcerated men nearing release. Preliminary efficacy of the MI intervention was also compared to an educational control group. Thirty-two men were assessed at baseline and randomized to one 90-min session. Assessment occurred 2 months after release. MI was feasibly administered, and participants were highly satisfied with both treatments. In addition, those who received MI reported higher rates of condom use with casual partners, higher rates of partner use of hormonal contraceptives, and slightly higher rates of sex that was protected against pregnancy. Increases are readiness to discuss family planning with sexual partners, as well as reported frequency of these discussions, and increases in family planning knowledge were also found in those randomized to MI. The findings from this study indicate the need to further assess MI with this population with a full-scale clinical trial. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Daniel J Delaney
- Department of Psychology, Chafee Social Science Center, University of Rhode Island
| | - L A R Stein
- Department of Psychology, Chafee Social Science Center, University of Rhode Island
| | - Shayna S Bassett
- Department of Psychology, Chafee Social Science Center, University of Rhode Island
| | - Jennifer G Clarke
- Center for Primary Care and Prevention, Memorial Hospital, Brown University
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Role of the Intersections of Gender, Race and Sexual Orientation in the Association between Substance Use Behaviors and Sexually Transmitted Infections in a National Sample of Adults with Recent Criminal Legal Involvement. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074100. [PMID: 35409785 PMCID: PMC8998534 DOI: 10.3390/ijerph19074100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 03/11/2022] [Accepted: 03/24/2022] [Indexed: 02/04/2023]
Abstract
Limited research has focused on how substance use and sexual risk behaviors differ among individuals impacted by the criminal legal system based on social identities. Using the National Survey on Drug Use and Health, we estimated relative risk for reporting a sexually transmitted infection (STI) among intersectional social groups with criminal legal involvement using a modified Poisson regression. We then utilized multivariate logistic regression and marginal effects to measure associations between substance use behaviors and STIs and to estimate whether these varied among the intersectional social groups with elevated STI rates. Three groups had elevated risk of reporting an STI compared to white, heterosexual men: white, heterosexual women (1.53, 95% CI: 1.05-2.20); Black, heterosexual women (2.03, 95% CI: 1.18-3.49); and white, gay or bisexual men (5.65, 95% CI: 2.61-12.20). Considering the intersections of gender, race, and sexual orientation, elevated risks for STIs among white and Black heterosexual women were mitigated after adjusting for substance use alongside other confounders. Only those who identified as white, gay or bisexual, and male had increased STI risk after controlling for substance use. Interventions targeting Black and white heterosexual women's sexual health following incarceration should focus on substance use and interventions targeting white, gay or bisexual men should focus on healthy sexual behaviors, HIV/STI screening, and care continuum efforts.
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Duncan DT, Callander D, Bowleg L, Park SH, Brinkley-Rubinstein L, Theall KP, Hickson DA. Intersectional analysis of life stress, incarceration and sexual health risk practices among cisgender Black gay, bisexual and other men who have sex with men in the Deep South of the US: the MARI Study. Sex Health 2021; 17:38-44. [PMID: 31972125 DOI: 10.1071/sh19062] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 08/05/2019] [Indexed: 11/23/2022]
Abstract
Objectives The purpose of the present study was to examine associations between life stress and incarceration history in relation to sexual health risk practices among a sample of cisgender Black gay, bisexual and other men who have sex with men (MSM) in the Deep South. METHODS Using data from a sample of 355 cisgender Black MSM in Mississippi and Georgia, multivariable logistic regression analyses were conducted to examine associations between life stress and sexual risk practices. In addition, we assessed whether stress may interact with experiences of incarceration to influence sexual health risk practices. RESULTS After controlling for sociodemographic characteristics, stress was associated with some sexual risk practices (e.g. alcohol and drug use during sex and group sex). Further, when an interaction with incarceration was assessed, among participants who had been incarcerated, high compared with low levels of stress were associated with alcohol use during sex (adjusted odds ratio (aOR) 4.59, 95% confidence interval (CI) 2.11-9.99, P < 0.001), drug use during sex (aOR 3.92, 95% CI 1.79-8.60, P < 0.001), condomless sex with casual partners (aOR 2.83, 95% CI 1.31-6.12, P < 0.001), having six or more casual partners (aOR 2.77, 95% CI 1.09-7.06, P = 0.02) and participating in group sex (aOR 5.67, 95% CI 2.07-15.51, P < 0.001). Stress and incarceration produced a dose-response effect for each association; similar associations with stress were not observed among men who had not been incarcerated. CONCLUSIONS Among people with experiences of incarceration, there are several possible ways our findings could be applied practically, including through safer sex and stress management interventions designed specifically for Black MSM following their release.
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Affiliation(s)
- Dustin T Duncan
- Department of Population Health, NYU School of Medicine, New York, NY 10016, USA; and Present address: Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY 10032, USA; and Corresponding author.
| | - Denton Callander
- Department of Population Health, NYU School of Medicine, New York, NY 10016, USA
| | - Lisa Bowleg
- Department of Psychology, Columbian College of Arts and Sciences, George Washington University, Washington, DC 20052, USA
| | - Su Hyun Park
- Department of Population Health, NYU School of Medicine, New York, NY 10016, USA
| | | | - Katherine P Theall
- Department of Global Community Health and Behavioral Sciences, Tulane University of School of Public Health and Tropical Medicine, New Orleans, LA 70112, USA
| | - DeMarc A Hickson
- Center for Research, Evaluation and Environmental and Policy Change, My Brother's Keeper Inc., Jackson, MS 39211, USA; and Us Helping Us, People Into Living, Washington, DC 20010, USA
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Zhao P, Tang W, Cheng H, Huang S, Zheng H, Yang B, Wang C. Uptake of provider-initiated HIV and syphilis testing among heterosexual STD clinic patients in Guangdong, China: results from a cross-sectional study. BMJ Open 2020; 10:e041503. [PMID: 33376172 PMCID: PMC7778783 DOI: 10.1136/bmjopen-2020-041503] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 12/03/2020] [Accepted: 12/12/2020] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Underscreening of HIV and syphilis in clinical settings is pervasive in resource-constrained settings. Heavy patient loads and competing health priorities in these settings inhibit provider's ability to meet screening coverage targets. The objective of this study was to examine determinants of provider-initiated HIV and syphilis testing uptake at sexually transmitted disease (STD) clinics in China. DESIGN A cross-sectional study was performed between July 2016 and December 2016. SETTING Seven STD clinics in Guangdong Province, China. PARTICIPANTS Heterosexual STD clinic patients met the inclusion criteria, regardless of their interest in receiving HIV or syphilis testing. OUTCOME MEASURES The syphilis and HIV testing uptake determined by patient receipt of results. RESULTS A total of 1943 individuals were recruited in this study. Among those participants, 60.6% (1177/1943) and 74.3% (1443/1943) conducted HIV testing and syphilis testing during the study, respectively, of whom, 2.2% (26/1177) and 21.5% (310/1443) were found to be HIV-positive and syphilis-positive, respectively. The most common reason for rejecting HIV and syphilis testing was a low self-perceived risk of HIV and syphilis infection. After adjusting for covariates, condom use in the last sexual act, consistent condom use in the last 6 months, having paid sex in the last 6 months and having received any kind of HIV/STD-related knowledge during the last 12 years were positively associated with both HIV and syphilis testing uptake. CONCLUSIONS The low-level of HIV and syphilis testing uptake, alongside with the high-level of engagement in risky sexual behaviours among heterosexual STD clinic patients, warranted a more targeted and intensive behavioural interventions to promote HIV and syphilis testing in this population.
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Affiliation(s)
- Peizhen Zhao
- STD Control Department, Dermatology Hospital, Southern Medical University, Guangzhou, China
- STD Control Department, Southern Medical University Institute for Global Health and Sexually Transmitted Diseases, Guangzhou, China
- STD Control Department, Guangdong Provincial Center for Skin Diseases and STIs Control, Guangzhou, China
| | - Weiming Tang
- STD Control Department, Dermatology Hospital, Southern Medical University, Guangzhou, China
- STD Control Department, Southern Medical University Institute for Global Health and Sexually Transmitted Diseases, Guangzhou, China
- STD Control Department, Guangdong Provincial Center for Skin Diseases and STIs Control, Guangzhou, China
- Project-China, University of North Carolina at Chapel Hill, Guangzhou, China
| | - Huanhuan Cheng
- Department of Ophthalmology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Shujie Huang
- STD Control Department, Dermatology Hospital, Southern Medical University, Guangzhou, China
- STD Control Department, Southern Medical University Institute for Global Health and Sexually Transmitted Diseases, Guangzhou, China
- STD Control Department, Guangdong Provincial Center for Skin Diseases and STIs Control, Guangzhou, China
| | - Heping Zheng
- STD Control Department, Dermatology Hospital, Southern Medical University, Guangzhou, China
- STD Control Department, Southern Medical University Institute for Global Health and Sexually Transmitted Diseases, Guangzhou, China
- STD Control Department, Guangdong Provincial Center for Skin Diseases and STIs Control, Guangzhou, China
| | - Bin Yang
- STD Control Department, Dermatology Hospital, Southern Medical University, Guangzhou, China
- STD Control Department, Southern Medical University Institute for Global Health and Sexually Transmitted Diseases, Guangzhou, China
- STD Control Department, Guangdong Provincial Center for Skin Diseases and STIs Control, Guangzhou, China
| | - Cheng Wang
- STD Control Department, Dermatology Hospital, Southern Medical University, Guangzhou, China
- STD Control Department, Southern Medical University Institute for Global Health and Sexually Transmitted Diseases, Guangzhou, China
- STD Control Department, Guangdong Provincial Center for Skin Diseases and STIs Control, Guangzhou, China
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Moradi G, Mohamadi-Bolbanabad A, Darvishi S, Azimian Zavareh F, Piroozi B, Zareie B, Gouya MM, Tashakorian M. Patterns of sexual behaviors and related factors among prisoners in Iran: results from a national survey in 2015. Int J Prison Health 2020; 16:29-37. [PMID: 32040273 DOI: 10.1108/ijph-10-2018-0052] [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
PURPOSE The purpose of this paper is to determine patterns of sexual behaviors and related factors among prisoners in Iran, 2015. DESIGN/METHODOLOGY/APPROACH This cross-sectional study was a part of a bio-behavioral surveillance survey conducted on 6,200 prisoners in 26 prisons in Iran. The subjects were selected through multi-stage sampling. Questionnaires and interviews were used to collect data on participant's demographics and history of sexual behaviors. Using STATA-12 software, the collected data were analyzed through descriptive statistics, and crude and adjusted logistic regression. FINDINGS A total of 5,508 prisoners with a response rate of 88.8 percent participated in this study. Of all prisoners, 55 percent (n=3,027) had a history of "unsafe sex in the lifetime" of whom 53.4 percent (n=1,549) never used condoms during unsafe sex in the lifetime. Based on the results of multivariate analysis, risk factors for "unsafe sex in lifetime" were the following: higher level of education (AOR=1.79, CI: 1.41-2.28), being single (AOR=1.32, CI: 1.18-1.47), unemployed before imprisonment (AOR=1.45, CI: 1.06-1.97), having history of previous imprisonment (AOR=1.31, CI: 1.17-1.47) and history of drug use in the lifetime (AOR=1.53, CI: 1.35-1.75). ORIGINALITY/VALUE Prisoners are high-risk groups that are prone to practice unsafe sex. Prisoners who are single, unemployed before imprisonment, a drug user, with a higher level of education and with a history of imprisonment are likely to be sexually active in their lifetime. Thus, they are a priority for receiving suitable interventions.
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Affiliation(s)
- Ghobad Moradi
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Amjad Mohamadi-Bolbanabad
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Sonia Darvishi
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Fatemeh Azimian Zavareh
- Centre for Communicable Diseases Control, Ministry of Health and Medical Education, Tehran, Iran
| | - Bakhtiar Piroozi
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Bushra Zareie
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Mohammad-Mehdi Gouya
- Centre for Communicable Diseases Control, Ministry of Health and Medical Education, Tehran, Iran
| | - Mehrzad Tashakorian
- Health and Treatment Directorate of Prisons and Security and Corrective Measures Organization, Tehran, Iran
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7
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Nowotny KM, Omori M, McKenna M, Kleinman J. Incarceration Rates and Incidence of Sexually Transmitted Infections in US Counties, 2011-2016. Am J Public Health 2020; 110:S130-S136. [PMID: 31967898 DOI: 10.2105/ajph.2019.305425] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Objectives. To examine rates of sexually transmitted infections as a function of jail and prison incarceration rates across US counties for the years 2011 to 2016.Methods. We used data from several national databases. The outcomes were county-level chlamydia and gonorrhea incidence as reported by the Centers for Disease Control and Prevention (2012-2016). The exposures were lagged specifications of county-level jail and prison incarceration rates as reported by the Vera Institute of Justice (2011-2015). We estimated mixed models to account for the 3 sources of response variable variation occurring across repeated measures collected from counties nested within states.Results. In the final model, jail and prison incarceration rates were associated with a rate increase of 10.13 per 100 000 and 8.22 per 100 000, respectively, of chlamydia incidence. The corresponding rate increases for gonorrhea incidence were 2.47 per 100 000 and 4.40 per 100 000.Conclusions. These findings provide some evidence that the documented differences in chlamydia and gonorrhea incidence between counties may be partially attributable to differences in jail and prison incarceration rates.
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Affiliation(s)
- Kathryn M Nowotny
- Kathryn M. Nowotny, Melanie McKenna, and Joshua Kleinman are with the Department of Sociology, University of Miami, Coral Gables, FL. Marisa Omori is with the Department of Criminology and Criminal Justice, University of Missouri-St. Louis
| | - Marisa Omori
- Kathryn M. Nowotny, Melanie McKenna, and Joshua Kleinman are with the Department of Sociology, University of Miami, Coral Gables, FL. Marisa Omori is with the Department of Criminology and Criminal Justice, University of Missouri-St. Louis
| | - Melanie McKenna
- Kathryn M. Nowotny, Melanie McKenna, and Joshua Kleinman are with the Department of Sociology, University of Miami, Coral Gables, FL. Marisa Omori is with the Department of Criminology and Criminal Justice, University of Missouri-St. Louis
| | - Joshua Kleinman
- Kathryn M. Nowotny, Melanie McKenna, and Joshua Kleinman are with the Department of Sociology, University of Miami, Coral Gables, FL. Marisa Omori is with the Department of Criminology and Criminal Justice, University of Missouri-St. Louis
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8
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Milburn NG, Hamilton AB, Lopez S, Wyatt GE. Mentoring the next generation of behavioral health scientists to promote health equity. THE AMERICAN JOURNAL OF ORTHOPSYCHIATRY 2019; 89:369-377. [PMID: 31070422 PMCID: PMC7577403 DOI: 10.1037/ort0000415] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Health inequities and disparities among various racial/ethnic minority, sexual minority, and rural populations are the focus of increasing national efforts. Three health problems disproportionately affecting these populations-HIV/AIDS, substance abuse, and trauma-deserve particular attention because of their harmful effects on health across the life span. To address these problems, our training program, the UCLA HIV/AIDS, Substance Abuse, and Trauma Training Program (HA-STTP), mentors and trains early career behavioral health scientists to conduct research using scientifically sound, culturally collaborative, and population-centered approaches. HA-STTP has been highly successful in training a diverse, productive, nationwide group of scholars. The program provides 2 years of training and mentorship to 20 (5 per year over 4 years) scholars. It is unique in its attention to traumatic stress as a form of dysregulation, particularly as experienced by underserved populations. Furthermore, our training program embraces a uniquely comprehensive, culturally grounded understanding of traumatic stress and its implications for substance abuse and HIV. HA-STTP advances scholars' knowledge of the interconnections among substance abuse, HIV/AIDS, traumatic stress, and health disparities, particularly in underrepresented populations; provides intensive mentorship to support scholars' research interests and career trajectories; capitalizes on a multidisciplinary, multiracial/ethnic network of expert faculty; and evaluates the program's impact on scholars' knowledge and productivity. By fostering the growth of scholars committed to conducting research with underrepresented populations that are disproportionately affected by HIV/AIDS, substance abuse, and traumatic stress, this program enhances nationwide efforts to diminish the prevalence of these problems and improve health and quality of life. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
- Norweeta G Milburn
- Department of Psychiatry and Biobehavioral Sciences, Division of Population Behavioral Health, Semel Institute for Neuroscience & Human Behavior, University of California
| | - Alison B Hamilton
- Department of Psychiatry and Biobhavioral Sciences, University of California, Los Angeles
| | - Susana Lopez
- Department of Psychiatry and Biobehavioral Sciences, Division of Population Behavioral Health, University of California
| | - Gail E Wyatt
- Department of Psychiatry and Biobhavioral Sciences, University of California, Los Angeles
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Brinkley-Rubinstein L, Peterson M, Arnold T, Nunn AS, Beckwith CG, Castonguay B, Junious E, Lewis C, Chan PA. Knowledge, interest, and anticipated barriers of pre-exposure prophylaxis uptake and adherence among gay, bisexual, and men who have sex with men who are incarcerated. PLoS One 2018; 13:e0205593. [PMID: 30532275 PMCID: PMC6286000 DOI: 10.1371/journal.pone.0205593] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 09/27/2018] [Indexed: 11/19/2022] Open
Abstract
Criminal justice (CJ) settings disproportionately include populations at high risk for acquiring HIV, and CJ-involved individuals are often at the intersection of multiple overlapping risk factors. However, few studies have examined attitudes about pre-exposure prophylaxis (PrEP) among incarcerated men who have sex with men (MSM). This study explored interest in, knowledge of, and barriers to PrEP uptake among gay, bisexual, and other men who have sex with men at the Rhode Island Department of Corrections. Using semi-structured interviews, 26 MSM were interviewed about PrEP knowledge, interest, timing preferences for provision (e.g. before or after release), and barriers to uptake and adherence during community re-entry. Interviews were coded and analyzed using a general inductive approach. Participants demonstrated low initial knowledge of PrEP but high interest after being told more about it. Participants self-identified risk factors for HIV acquisition, including condomless sex and substance use. In addition, participants preferred provision of PrEP prior to release. Post-release barriers to PrEP uptake and adherence included 1) concerns about costs of PrEP medications; 2) anticipated partner or family disapproval; 3) lack of access to transportation; 4) unstable housing; 5) compounding impacts of multiple hardships leading to a de-prioritization of PrEP and 6) fears of future re-incarceration. These results point to the need for future PrEP interventions among incarcerated populations that address incarceration and PrEP related barriers during community re-entry via wraparound services that address PrEP and incarceration-related barriers.
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Affiliation(s)
- Lauren Brinkley-Rubinstein
- Department of Social Medicine, University of North Carolina, Chapel Hill, North Carolina, United States of America
- Center for Health Equity Research, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Meghan Peterson
- Center for Prisoner Health and Human Rights, The Miriam Hospital, Providence, Rhode Island, United States of America
| | - Trisha Arnold
- Department of Psychology, Jackson State University, Jackson, Missouri, United States of America
- Rhode Island Hospital, Providence, Rhode Island, United States of America
| | - Amy S. Nunn
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island, United States of America
| | - Curt G. Beckwith
- Department of Medicine, Brown University, Providence, Rhode Island, United States of America
| | - Breana Castonguay
- Center for AIDS Research, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Eric Junious
- College of Health and Human Services, University of North Carolina, Charlotte, North Carolina, United States of America
| | - Chantal Lewis
- Center for Health Equity Research, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Philip A. Chan
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island, United States of America
- Department of Medicine, Brown University, Providence, Rhode Island, United States of America
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10
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Rowell-Cunsolo TL, Long Y, Szeto B, Mkuu R, El-Bassel N. Examining factors associated with unprotected sexual behavior among Black Americans postrelease from incarceration in New York City. JOURNAL OF OFFENDER REHABILITATION 2018; 57:330-342. [PMID: 31649474 PMCID: PMC6812487 DOI: 10.1080/10509674.2018.1487899] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2017] [Revised: 07/05/2017] [Accepted: 12/27/2017] [Indexed: 06/10/2023]
Abstract
Black Americans are overrepresented among incarcerated individuals and those infected with sexually transmitted infections. We assessed unprotected sexual behavior among 165 formerly incarcerated Black Americans in New York City, New York. Most participants (63%) reported engaging in unprotected sexual behavior post-incarceration. According to our regression results, less time spent in jail and reporting multiple sexual partnerships were associated with a greater likelihood of engaging in unprotected sexual behavior. High rates of unprotected sexual behavior may place formerly incarcerated Black Americans at risk for sexually transmitted infections. Discharge planning programs that include STI/HIV prevention information and education may be useful for this population.
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Affiliation(s)
- Tawandra L. Rowell-Cunsolo
- corresponding author Tawandra L. Rowell-Cunsolo
PhD, Assistant Professor of Social Welfare Science, Columbia University, School
of Nursing, 617 West 168th Street, New York, NY 10032, 212-305-8611 (Phone),
212-543-6003 (Fax),
| | - Yue Long
- Columbia University, Quantitative Methods in the Social Sciences,
New York, NY
| | - Betsy Szeto
- Columbia University, College of Physicians & Surgeons, New
York, NY
| | - Rahma Mkuu
- Texas A & M University, College Station, TX
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11
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Peterson M, Nowotny K, Dauria E, Arnold T, Brinkley-Rubinstein L. Institutional distrust among gay, bisexual, and other men who have sex with men as a barrier to accessing pre-exposure prophylaxis (PrEP). AIDS Care 2018; 31:364-369. [PMID: 30227719 DOI: 10.1080/09540121.2018.1524114] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Populations at highest risk for acquiring HIV are more likely to pass through criminal justice (CJ) settings, and CJ-involved individuals are often at the intersection of multiple overlapping risk factors. The present study explored interest in, knowledge of, and barriers to PrEP uptake among gay, bisexual, and other men who have sex with men involved in the criminal justice system. Using semi-structured interviews, 26 participants who identified as MSM were asked about PrEP knowledge and interest, HIV risk, and incarceration experience. One theme that emerged across interviews was how institutional distrust in CJ settings may instill lack of trust in medical care after perceived mistreatment. Participants explained how lack of privacy fostered feelings that medical care was not confidential, care received was tied to status as an incarcerated person, and feelings of dehumanization led to distrust. Findings explore how distrust may hinder PrEP uptake and other HIV prevention efforts in CJ settings as well as after release. They highlight the need for greater privacy efforts and cultural humility, and explore how medical settings may function as spaces for people who are incarcerated to disclose HIV risk status. Few studies to our knowledge have examined the role of institutional distrust on men who have sex with men (MSM) in the context of pre-exposure prophylaxis (PrEP) interventions. The present study has implications for creating best practices to structure HIV prevention interventions in CJ settings.
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Affiliation(s)
- Meghan Peterson
- a School of Public Health , Brown University , Providence , RI , USA.,b Center for Prisoner Health and Human Rights , Miriam Hospital , Providence , RI , USA
| | - Kathryn Nowotny
- c Department of Sociology , University of Miami , Miami , FL , USA
| | - Emily Dauria
- d Department of Psychiatry , University of California , San Francisco , CA , USA
| | - Trisha Arnold
- e Department of Psychology , Rhode Island Hospital , Providence , RI , USA
| | - Lauren Brinkley-Rubinstein
- f Department of Social Medicine , University of North Carolina , Chapel Hill , NC , USA.,g Center for Health Equity Research , University of North Carolina , Chapel Hill , NC , USA
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Associations between mass incarceration and community health in New York City. Public Health 2018; 161:43-48. [DOI: 10.1016/j.puhe.2018.04.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Revised: 04/06/2018] [Accepted: 04/29/2018] [Indexed: 11/18/2022]
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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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