Timing and duration of incarceration and high-risk sexual partnerships among African Americans in North Carolina.
OBJECTIVE
Incarceration may contribute to HIV transmission by disrupting stable partnerships and promoting high-risk partnerships. We investigated incarceration and high-risk partnerships among African Americans in North Carolina.


METHODS
We conducted a weighted analysis using the North Carolina Rural Health Project (N = 320), a population-based case-control study of HIV among African Americans. We measured associations between timing and duration of incarceration and high-risk partnerships (multiple partnerships or sex trade for money or drugs).


RESULTS
Duration of incarceration appeared to be more important than how long ago incarceration occurred. After adjustment for sociodemographic indicators, high-risk partnerships were associated with short-term (<1 month) incarceration of the respondent versus no respondent incarceration (men: adjusted prevalence ratio (aPR) 1.9, 95% confidence interval (95% CI) 1.2-2.8; women: aPR 3.1, 95% CI 1.2-8.3). High-risk partnerships also were associated with incarceration of a partner versus no partner incarceration (men: aPR 1.8, 95% CI 1.1-3.0; women: aPR 2.0, 95% CI 1.1-3.8). Among men, associations remained when adjusting for substance use. Among women, adjustment for substance use weakened estimates due to the strong correlation between substance use and incarceration.


CONCLUSIONS
HIV-prevention programs targeting currently and formerly incarcerated individuals and their partners may decrease HIV in African American communities with high incarceration rates.
Khan
Maria R
MR
Department of Epidemiology, University of North Carolina at Chapel Hill, NC, USA. maria_khan@unc.edu
Miller
William C
WC
Schoenbach
Victor J
VJ
Weir
Sharon S
SS
Kaufman
Jay S
JS
Wohl
David A
DA
Adimora
Adaora A
AA
D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000208:ethnology / Q000635:transmission; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009657:North Carolina / Q000453:epidemiology; D016012:Poisson Distribution; D011329:Prisoners / Q000706:statistics & numerical data*; D012423:Rural Health; D012737:Sex Factors; D012959:Socioeconomic Factors; D047568:Unsafe Sex / Q000706:statistics & numerical data*