title: Gender Differences in HIV Risk Behaviors Among Persons Involved in the U.S. Criminal Justice System and Living with HIV or at Risk for HIV: A "Seek, Test, Treat, and Retain" Harmonization Consortium.
abstract: The U.S. female criminal justice (CJ) population is rapidly growing, yet large-scale studies exploring gender-specific HIV risk behaviors in the CJ population are lacking. This analysis uses baseline data on adults with a CJ history from eight U.S. studies in an NIH-funded "Seek, Test, Treat, Retain" harmonization consortium. Data were collected using a standardized HIV risk behavior assessment tool and pooled across studies to describe participants' characteristics and risk behaviors. Multilevel mixed-effects logistic regression models were used to test for gender-based behavior differences. Among 784 HIV-positive (21.4% female) and 5521 HIV-negative (8.5% female) participants, HIV-positive women had higher odds than HIV-positive men of engaging in condomless sexual intercourse (AOR 1.84 [1.16-2.95]) with potentially sero-discordant partners (AOR 2.40 [1.41-4.09]) and of sharing injection equipment (AOR 3.36 [1.31-8.63]). HIV risk reduction interventions targeting CJ-involved women with HIV are urgently needed as this population may represent an under-recognized potential source of HIV transmission.
authors.affiliation: Yale University AIDS Program, Yale School of Medicine, New Haven, CT, USA. kelsey.loeliger@yale.edu.|Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA. kelsey.loeliger@yale.edu.
authors.forename: Kelsey B
authors.identifier: http://orcid.org/0000-0002-1193-4357
authors.initials: KB
authors.lastname: Loeliger
authors.affiliation: Department of Biostatistics, University of Washington, Seattle, WA, USA.
authors.forename: Mary L
authors.initials: ML
authors.lastname: Biggs
authors.affiliation: Department of Biostatistics, University of Washington, Seattle, WA, USA.
authors.forename: Rebekah
authors.initials: R
authors.lastname: Young
authors.affiliation: Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA.
authors.forename: David W
authors.initials: DW
authors.lastname: Seal
authors.affiliation: Department of Medicine/Infectious Diseases, The Miriam Hospital/Alpert Medical School of Brown University, Providence, RI, USA.
authors.forename: Curt G
authors.initials: CG
authors.lastname: Beckwith
authors.affiliation: Department of Epidemiology and Biostatistics, George Washington University Milken Institute School of Public Health, Washington, DC, USA.
authors.forename: Irene
authors.initials: I
authors.lastname: Kuo
authors.affiliation: Friends Research Institute Inc., Baltimore, MD, USA.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Gordon
authors.affiliation: Yale University AIDS Program, Yale School of Medicine, New Haven, CT, USA.|Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA.|Centre of Excellence on Research in AIDS (CERiA), University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Frederick L
authors.initials: FL
authors.lastname: Altice
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, IL, USA.
authors.forename: Lawrence J
authors.initials: LJ
authors.lastname: Ouellet
authors.affiliation: Division of General Internal Medicine and Health Services Research, Department of Medicine, Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.|Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA.
authors.forename: William E
authors.initials: WE
authors.lastname: Cunningham
authors.affiliation: Division of Infectious Diseases, Immunology and International Medicine, Department of Medicine, University of Illinois at Chicago, Chicago, IL, USA.
authors.forename: Jeremy D
authors.initials: JD
authors.lastname: Young
authors.affiliation: Yale University AIDS Program, Yale School of Medicine, New Haven, CT, USA.
authors.forename: Sandra A
authors.initials: SA
authors.lastname: Springer
mesh_terms: D000328:Adult; D003416:Criminal Law; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000517:prevention & control*; D006297:Health Services Accessibility; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011330:Prisons; D012309:Risk-Taking; D012737:Sex Factors; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D012747:Sexual Partners; D015819:Substance Abuse, Intravenous / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: Criminal justice system; HIV/AIDS; Injection drug use risk behaviors; Sexual risk behaviors; Women and gender differences