title: Love on lockdown: how social network characteristics predict separational concurrency among low income African-American women.
abstract: One out of nine African-American men between the ages of 20 and 34 is behind bars, resulting in many African-American women losing their primary romantic partners to incarceration. Research suggests that partner incarceration may contribute to increased risk of sexually transmitted infections (STIs)/human immunodeficiency virus (HIV); however, factors associated with women's decisions to begin new sexual partnerships following partner incarceration (i.e., separational concurrency) have not been well studied. This study examined the social context relevant to initiating separational concurrency, following incarceration of a primary male partner. Cross-sectional secondary data analysis of 6-month follow-up data from the CHAT Project, a social-network based HIV/sexually transmitted disease (STD) prevention study in Baltimore, MD, USA. Participants were N = 196 African-American women, who reported ever having had a partner who was incarcerated for at least 6 months during the relationship. The majority (81.5%) of women were unemployed with a mean age of 41.7 years. Over half of the sample (59.5%) reported having used crack or heroin at least once in the previous 12 months; 48.5% of the women had experienced physical abuse, with over half of the sample reporting a lifetime history of emotional abuse (54.6%). Separational concurrency, defined as answering yes to the item, "While [your] partner was incarcerated, did you have any other sexual partners?," was the primary outcome measure. After adjusting for age, drug use and unemployment the multiple logistic regression model found that women who reported a history of physical or emotional abuse were over two times as likely to report separational concurrency than women without an abuse history [adjusted odds ratio (AOR), 2.24; 95% CI, 1.24, 4.05; p = .007 and AOR, 2.44; 95% CI, 1.33, 4.46; p = .004, respectively]. Individuals who reported a higher number of drug-using sex partners (AOR, 2.49; 95% CI, 1.4, 4.5; p = .002), sex exchange partners (AOR, 4.0; 95% CI, 1.8 8.9; p = .001), and sexual partners who engaged in concurrency (AOR: 2.67; 95% CI: 1.5, 4.8; p = .001) were significantly more likely to report separational concurrency. Conversely, participants who reported more female kin in their social networks (AOR, .808; 95% CI, .67, .97; p = .025), having known network members a longer time (AOR, .997; 95% CI, .993, .999; p = .043), and higher levels of trust for network members (AOR, .761; 95% CI, .63, .92; p = .005) were significantly less likely to report separational concurrency. Results of this study demonstrate that social network characteristics may be crucial to understanding separational concurrency among African-American urban women who have lost a partner to incarceration. Social network and other resource-based interventions, which provide instrumental, social, and economic resources to women who have experienced the loss of a partner to incarceration, may be important tools in empowering women and helping to reduce the disproportionate burden of STIs/HIV among low income, African-American women.
authors.affiliation: Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21231, USA, Kking40@jhu.edu.
authors.forename: Kelly M
authors.initials: KM
authors.lastname: King
authors.forename: Carl A
authors.initials: CA
authors.lastname: Latkin
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Davey-Rothwell
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D015142:Baltimore / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011203:Poverty / Q000706:statistics & numerical data*; D011329:Prisoners / Q000706:statistics & numerical data*; D012307:Risk Factors; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000453:epidemiology; D012944:Social Support; D055815:Young Adult
references.citation: Annu Rev Public Health. 2012 Apr;33:325-39
references.pmid: 22224880
references.citation: Am J Drug Alcohol Abuse. 1999 Aug;25(3):463-73
references.pmid: 10473009
references.citation: Int J STD AIDS. 2003 Nov;14(11):770-5
references.pmid: 14624742
references.citation: Ethn Dis. 2003 Summer;13(3):362-8
references.pmid: 12894961
references.citation: Sex Transm Dis. 2002 Aug;29(8):453-62
references.pmid: 12172529
references.citation: Health Educ Behav. 2000 Oct;27(5):539-65
references.pmid: 11009126
references.citation: Am J Epidemiol. 1982 Jan;115(1):92-106
references.pmid: 7055134
references.citation: AIDS Behav. 2010 Feb;14(1):38-47
references.pmid: 18483847
references.citation: Arch Sex Behav. 2011 Aug;40(4):775-84
references.pmid: 21052812
references.citation: Violence Against Women. 2010 Mar;16(3):348-54
references.pmid: 20133922
references.citation: Cult Health Sex. 2011 May;13(5):545-59
references.pmid: 21390949
references.citation: Ann Epidemiol. 2004 Mar;14(3):155-60
references.pmid: 15036217
references.citation: Sex Transm Dis. 2001 Feb;28(2):69-76
references.pmid: 11234788
references.citation: J Acquir Immune Defic Syndr Hum Retrovirol. 1996 Nov 1;13(3):273-80
references.pmid: 8898673
references.citation: J Health Care Poor Underserved. 2013 Feb;24(1):78-88
references.pmid: 23377719
references.citation: Public Health Rep. 2010 Jul-Aug;125 Suppl 4:70-80
references.pmid: 20626195
references.citation: Lancet. 2008 Jul 26;372(9635):337-40
references.pmid: 18657713
references.citation: Sex Transm Dis. 2011 Jan;38(1):43-7
references.pmid: 20739913
references.citation: Subst Use Misuse. 2007;42(11):1629-49
references.pmid: 17934988
references.citation: AIDS Behav. 2012 May;16(4):882-9
references.pmid: 21861193
references.citation: J Urban Health. 2001 Jun;78(2):214-35
references.pmid: 11419576
references.citation: Am J Public Health. 2009 Apr;99(4):666-72
references.pmid: 19150898
references.citation: Subst Use Misuse. 2014 Jan 1;49(1-2):176-188
references.pmid: 23964987
references.citation: J Health Soc Behav. 2007 Jun;48(2):115-30
references.pmid: 17583269
references.citation: Sex Transm Dis. 2006 Jul;33(7 Suppl):S6-10
references.pmid: 16794556
references.citation: Sociol Health Illn. 2007 Jul;29(5):633-55
references.pmid: 17714335
references.citation: Child Dev. 1995 Dec;66(6):1585-97
references.pmid: 8556887
references.citation: Am J Public Health. 2007 Dec;97(12):2230-7
references.pmid: 17971556
references.citation: J Infect Dis. 2005 Feb 1;191 Suppl 1:S55-60
references.pmid: 15627231
references.citation: J Urban Health. 2008 Sep;85(5):717-26
references.pmid: 18553223