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High-Risk Behaviors During Incarceration in African-American Men Treated for HIV at Three Los Angeles Public Medical Centers

Wohl, Amy Rock; Johnson, Denise; Jordan, Wilbert; Lu, Sharon; Beall, Gildon; Currier, Judith; Kerndt, Peter R.
JAIDS Journal of Acquired Immune Deficiency Syndromes: August 1st, 2000
EPIDEMIOLOGY: PDF Only

Objectives:This paper describes research that examined the association between high-risk sexual and drug-using behaviors during incarceration and HIV infection for African-American men receiving HIV care at three public medical centers in Los Angeles County (LAC), California.

Methods:A case-control study was conducted in which 305 HIV-infected African-American men and 305 neighborhood controls, ages 20 to 49, were frequency-matched by age.

Results:After controlling for anal sex while not incarcerated, we found no association between anal sex during incarceration and HIV (odds ratio [OR], 1.1; 95% confidence interval [CI], 0.6-2.2). Among men with a history of incarceration (n = 332), the percentage reporting anal sex with men outside of incarceration (45%) was greater than those reporting anal sex while incarcerated (16%). Injection drug use (IDU) during incarceration was also not associated with HIV when controlling for IDU outside of incarceration (OR, 1.6; 95% CI, 0.5- 4.9). Increased time in jail or prison was associated with less HIV infection (p = .001).

Conclusions:Although high-risk behaviors are more common in the community than in the incarcerated setting for this study group, incarcerated populations represent a high-risk group for whom access to prevention messages is limited. Periods of incarceration represent a unique opportunity to convey prevention messages that focus on high-risk behaviors outside the incarcerated setting.

Address correspondence and reprint requests to Amy Rock Wohl, HIV Epidemiology Program, 600 South Commonwealth Avenue, Suite 805, Los Angeles, CA 90005, U.S.A.; email: awohl@dhs.co.la.ca.us.

Manuscript received October 4, 1999; accepted March 23, 2000.

© 2000 Lippincott Williams & Wilkins, Inc.