Incarceration and unstable housing interact to predict sexual risk behaviours among African American STD clinic patients.
Given the dramatic racial disparities in the rates of HIV/sexually transmitted infections (STIs) among African Americans, understanding broader structural factors that increase the risk for HIV/STIs is crucial. This study investigated incarceration history and unstable housing as two structural predictors of HIV risk behaviour among 293 African Americans (159 men/134 women, mean age = 27). Participants were recruited from an urban sexually transmitted disease (STD) clinic in the southeastern U.S. Approximately half the sample had been incarcerated in their lifetime (54%), and 43% had been unstably housed in the past six months. Incarceration was independently associated with the number of sex partners and the frequency of unprotected sex. Unstable housing was independently associated with the frequency of unprotected sex. However, these main effects were qualified by significant interactions: individuals with a history of incarceration and more unstable housing had more sex partners and more unprotected sex in the past three months than individuals without these structural barriers. Implications for structural-level interventions are discussed.
Department of Psychology, University of North Carolina, Chapel Hill, NC, USA.
Laura
L
Widman
Seth M
SM
Noar
Carol E
CE
Golin
Jessica F
JF
Willoughby
Richard
R
Crosby
D000328:Adult; D001741:Black or African American / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000208:ethnology / Q000517:prevention & control* / Q000635:transmission; D054624:Health Status Disparities; D006798:Housing; D006801:Humans; D008297:Male; D008875:Middle Aged; D011329:Prisoners / Q000706:statistics & numerical data*; D012307:Risk Factors; D012309:Risk-Taking; D012725:Sexual Behavior; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000208:ethnology / Q000517:prevention & control* / Q000635:transmission; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology
HIV/AIDS; housing; incarceration; racial disparities; sexual risk behaviour; sexually transmitted infections; structural factors