The Committed Intimate Partnerships of Incarcerated African-American Men: Implications for Sexual HIV Transmission Risk and Prevention Opportunities.
Incarceration is thought to influence HIV transmission by disrupting partnerships that provide support and protect against sex risk-taking. Current correctional facility-based family-strengthening programs focus on marital partnerships, a minority of inmates' partnerships. Research on the sex partnerships of incarcerated African-American men and the types of partnerships most likely to protect against HIV-related sex risk is limited. Improved understanding can inform expansion of correctional facility-based family-strengthening programs to a greater proportion of protective partnerships and HIV risk reduction programs to partnerships vulnerable to sex risk. Project DISRUPT is a cohort study of African-American men being released from prison in North Carolina who were in committed heterosexual partnerships at prison entry. Using baseline survey data (N = 189), we conducted latent class analysis (LCA) to identify subgroups of participants with distinct relationship profiles and measured associations between relationship characteristics and multiple partnerships of inmates and their partners in the six months before incarceration. LCA indicated a two-class solution, with relationships distinguished by satisfaction/stability (satisfied/stable class: 58.0%; dissatisfied/unstable class: 42.0%); each class had comparable relationship length and levels of marriage and cohabitation. Dissatisfied/unstable relationships were associated with multiple partnerships among participants (AOR 2.93, 95% CI 1.50, 5.72) and partners (AOR 4.95, 95% CI 1.68, 14.58). Satisfaction indicators-versus length, marriage, or cohabitation-were the strongest independent correlates of inmates' and partners' multiple partnerships. Pre-incarceration economic deprivation, mental disorder symptoms, substance use, and violence in relationships were associated with dissatisfaction/instability. Prison-based programs designed to maintain healthy partnerships, strengthen relationship skills, and reduce HIV risk-taking and violence in relationships are warranted and should be targeted to both marital and nonmarital partnerships. Programming also should address the poverty, mental illness, and substance use factors that threaten relationship satisfaction/stability and increase HIV risk.
Division of Comparative Effectiveness and Decision Science, Department of Population Health, New York University School of Medicine, 227 East 30th Street, New York, NY, 10016, USA. maria.khan@nyumc.org.
Maria R
MR
Khan
Social Intervention Group, Columbia University, New York, NY, USA.
Nabila
N
El-Bassel
Division of General Internal Medicine and Epidemiology, Department of Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.|Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Carol E
CE
Golin
Division of Comparative Effectiveness and Decision Science, Department of Population Health, New York University School of Medicine, 227 East 30th Street, New York, NY, 10016, USA.
Joy D
JD
Scheidell
Division of Infectious Disease, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA.|Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Adaora A
AA
Adimora
Department of Epidemiology, University of Florida College of Public Health and Health Professions, College of Medicine, Gainesville, FL, USA.
Ashley M
AM
Coatsworth
Department of Epidemiology, University of Florida College of Public Health and Health Professions, College of Medicine, Gainesville, FL, USA.
Hui
H
Hu
Division of Infectious Disease, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA.
Selena
S
Judon-Monk
Division of Infectious Disease, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA.
Katie P
KP
Medina
Division of Infectious Disease, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA.
David A
DA
Wohl
D000328:Adult; D001741:Black or African American; D015331:Cohort Studies; D015658:HIV Infections / Q000517:prevention & control / Q000635:transmission*; D006801:Humans; D008297:Male; D011329:Prisoners / Q000523:psychology / Q000706:statistics & numerical data*; D012309:Risk-Taking; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000517:prevention & control / Q000635:transmission*
Committed partnerships; HIV; Incarceration; Sexual risk behavior