Incarceration and Sexually Transmitted Infections
Incarceration and Sexually Transmitted Infections
Objectives The authors examined the associations between personal and partner incarceration, high-risk sexual partnerships and biologically confirmed sexually transmitted infection (STI) in a US urban population.
Methods Data from a probability survey of young adults 15–35 years of age in Baltimore, Maryland, USA, were analysed to assess the prevalence of personal and partner incarceration and its association with several measures of high-risk sexual partnerships including multiple partners, partner concurrency and current STI.
Results A history of incarceration was common (24.1% among men and 11.3% among women). Among women with an incarcerated partner in the past year (15.3%), the risk of current STI was significantly increased (adjusted prevalence ratio=2.3, 95% CI 1.5 to 3.5). Multiple partners (5+) in the past year and partner concurrency were disproportionately high among men and women who had been incarcerated or who had sexual partner(s) or who had recently been incarcerated. These associations remained robust independent of personal socio-demographic factors and illicit drug use.
Conclusions Incarceration may contribute to STI risk by influencing engagement in high-risk behaviours and by influencing contact with partners who engage in risky behaviours and who hence have elevated risk of infection.
Populations with a history of incarceration and members of their sexual networks more frequently engage in high-risk sexual partnerships compared with those with no exposure to incarceration. Behaviours such as having multiple and concurrent partners influence the risk of sexually transmitted infections (STIs), but social and economic instability and substance use may also contribute to increased STI risk among incarcerated populations and their partners. Several studies have indicated that incarceration and/or incarceration of a sex partner are correlates of STI-related sexual risk behaviours independent of adverse demographic and socioeconomic factors, including poverty and substance use, suggesting that incarceration itself may influence STI risk. Incarceration may contribute to sexual risk behaviours and STIs by disrupting sexual networks, leading to increased levels of sexual partnership exchange and/or by increasing links between high- and low-risk individuals, resulting in increasing levels of STI-discordant partnerships. Whether these associations are consistently observed in well-defined population samples, in addition to samples in prison and jail settings, needs to be evaluated.
In this paper, we examine associations between personal and partner incarceration and measures of sexual risk and current STI status in a probability sample of young adults in Baltimore, Maryland, an urban community with high rates of STIs and incarceration. We analyse data from the 2006–2009 Monitoring STIs Survey Program (MSSP), a population-based behavioural survey of Baltimore residents aged 15–35 years that included biospecimen collection for testing of three STIs (trichomoniasis, gonorrhoea and chlamydial infection). We use these data to investigate whether individual and partner's incarceration are independently associated with multiple partnerships, partner concurrency and biologically confirmed STI at the population level.
Abstract and Introduction
Abstract
Objectives The authors examined the associations between personal and partner incarceration, high-risk sexual partnerships and biologically confirmed sexually transmitted infection (STI) in a US urban population.
Methods Data from a probability survey of young adults 15–35 years of age in Baltimore, Maryland, USA, were analysed to assess the prevalence of personal and partner incarceration and its association with several measures of high-risk sexual partnerships including multiple partners, partner concurrency and current STI.
Results A history of incarceration was common (24.1% among men and 11.3% among women). Among women with an incarcerated partner in the past year (15.3%), the risk of current STI was significantly increased (adjusted prevalence ratio=2.3, 95% CI 1.5 to 3.5). Multiple partners (5+) in the past year and partner concurrency were disproportionately high among men and women who had been incarcerated or who had sexual partner(s) or who had recently been incarcerated. These associations remained robust independent of personal socio-demographic factors and illicit drug use.
Conclusions Incarceration may contribute to STI risk by influencing engagement in high-risk behaviours and by influencing contact with partners who engage in risky behaviours and who hence have elevated risk of infection.
Introduction
Populations with a history of incarceration and members of their sexual networks more frequently engage in high-risk sexual partnerships compared with those with no exposure to incarceration. Behaviours such as having multiple and concurrent partners influence the risk of sexually transmitted infections (STIs), but social and economic instability and substance use may also contribute to increased STI risk among incarcerated populations and their partners. Several studies have indicated that incarceration and/or incarceration of a sex partner are correlates of STI-related sexual risk behaviours independent of adverse demographic and socioeconomic factors, including poverty and substance use, suggesting that incarceration itself may influence STI risk. Incarceration may contribute to sexual risk behaviours and STIs by disrupting sexual networks, leading to increased levels of sexual partnership exchange and/or by increasing links between high- and low-risk individuals, resulting in increasing levels of STI-discordant partnerships. Whether these associations are consistently observed in well-defined population samples, in addition to samples in prison and jail settings, needs to be evaluated.
In this paper, we examine associations between personal and partner incarceration and measures of sexual risk and current STI status in a probability sample of young adults in Baltimore, Maryland, an urban community with high rates of STIs and incarceration. We analyse data from the 2006–2009 Monitoring STIs Survey Program (MSSP), a population-based behavioural survey of Baltimore residents aged 15–35 years that included biospecimen collection for testing of three STIs (trichomoniasis, gonorrhoea and chlamydial infection). We use these data to investigate whether individual and partner's incarceration are independently associated with multiple partnerships, partner concurrency and biologically confirmed STI at the population level.
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