title: High-risk behaviors during incarceration in African-American men treated for HIV at three Los Angeles public medical centers.
abstract: OBJECTIVE
  This paper describes research that examined the association between high-risk sexual and drug-using behaviors during incarceration and HIV infection for African-American men receiving HIV care at three public medical centers in Los Angeles County (LAC), California.
  
  
  METHODS
  A case-control study was conducted in which 305 HIV-infected African-American men and 305 neighborhood controls, ages 20 to 49, were frequency-matched by age.
  
  
  RESULTS
  After controlling for anal sex while not incarcerated, we found no association between anal sex during incarceration and HIV (odds ratio [OR], 1.1; 95% confidence interval [CI], 0.6-2.2). Among men with a history of incarceration (n = 332), the percentage reporting anal sex with men outside of incarceration (45%) was greater than those reporting anal sex while incarcerated (16%). Injection drug use (IDU) during incarceration was also not associated with HIV when controlling for IDU outside of incarceration (OR, 1.6; 95% CI, 0.5- 4.9). Increased time in jail or prison was associated with less HIV infection (p =.001).
  
  
  CONCLUSIONS
  Although high-risk behaviors are more common in the community than in the incarcerated setting for this study group, incarcerated populations represent a high-risk group for whom access to prevention messages is limited. Periods of incarceration represent a unique opportunity to convey prevention messages that focus on high-risk behaviors outside the incarcerated setting.
authors.affiliation: HIV Epidemiology Program, Los Angeles County Department of Health Services, Los Angeles, CA, USA. awohl@dhs.co.la.ca.us
authors.forename: A R
authors.initials: AR
authors.lastname: Wohl
authors.forename: D
authors.initials: D
authors.lastname: Johnson
authors.forename: W
authors.initials: W
authors.lastname: Jordan
authors.forename: S
authors.initials: S
authors.lastname: Lu
authors.forename: G
authors.initials: G
authors.lastname: Beall
authors.forename: J
authors.initials: J
authors.lastname: Currier
authors.forename: P R
authors.initials: PR
authors.lastname: Kerndt
mesh_terms: D000328:Adult; D001741:Black or African American; D016022:Case-Control Studies; D015658:HIV Infections / Q000150:complications / Q000523:psychology*; D018451:Homosexuality, Male; D006801:Humans; D015141:Los Angeles; D008297:Male; D008875:Middle Aged; D011329:Prisoners; D012309:Risk-Taking; D012725:Sexual Behavior; D015819:Substance Abuse, Intravenous / Q000150:complications