Exploring the Relationship Between Incarceration and HIV Among Black Men Who Have Sex With Men in the United States

Brewer, Russell A. DrPH, CHES*; Magnus, Manya PhD, MPH; Kuo, Irene PhD, MPH; Wang, Lei PhD; Liu, Ting-Yuan MS; Mayer, Kenneth H. MD§,‖,¶

JAIDS Journal of Acquired Immune Deficiency Syndromes:
doi: 10.1097/01.qai.0000434953.65620.3d
Epidemiology and Prevention
Abstract

Abstract: This study examined the predictors of new incarceration and their association with HIV infection among 1278 black men who have sex with men enrolled and followed up in the HIV Prevention Trials Network 061 study. HIV Prevention Trials Network 061 was conducted to determine the feasibility and acceptability of a multicomponent intervention to reduce HIV infection among BMSM in 6 US cities. In this study, multivariable logistic regression models were used to explore the association between incarceration during study follow-up and several demographic, behavioral, and psychosocial variables at baseline found to be significant in bivariate analyses. In addition, Cox proportional hazard regression was used to explore the association between incarceration during study follow-up and incident HIV infection. Among the 1278 BMSM with follow-up data, 305 (24%) reported a new incarceration within 1 year of entering the study with an estimated incarceration incidence of 35% (95% confidence interval: 31% to 38%). After adjusting for confounders, lower education, lower annual income, previous incarceration frequency, and higher levels of perceived racism were significantly associated with new incarcerations during study follow-up. There was no observed association between incarceration during study follow-up and incident HIV infection. The very high level of new incarcerations highlights the importance of structural-level interventions to prevent incarceration among economically disenfranchised black men who have sex with men in the United States.

Author Information

*HIV, STDs, and Reproductive Health Program, Louisiana Public Health Institute, New Orleans, LA;

Department of Epidemiology and Biostatistics, The George Washington University School of Public Health and Health Services, Washington, DC;

Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA;

§Fenway Health and Infectious Disease Division, The Fenway Institute, Boston, MA;

Beth Israel Deaconess Hospital, Boston, MA; and

Harvard Medical School, Boston, MA.

Correspondence to: Russell A. Brewer, DrPH, CHES, Louisiana Public Health Institute, 1515 Poydras Street, Suite 1200, New Orleans, LA 70112 (e-mail:rbrewer@lphi.org).

R.A.B. generated the initial concept, reviewed the analysis results, drafted the initial article, updated subsequent drafts, and completed the final version for publication. M.M., I.K., and K.H.M. also helped to create the initial concept, reviewed the analysis results, and revised the initial and subsequent drafts. In addition, M.M. and I.K. served as HPTN 061 site co-principal investigators, and K.H.M. served as the HPTN 061 study Co-Chair. L.W. and T.Y.L. ran the analyses, reviewed the analysis results, and revised the initial and subsequent drafts.

Human Participation Protection: Each of the 6 participating sites received its own Institutional Review Board approval for the study.

Supported by NIAID, NIDA, and NIMH under cooperative agreement #UM1 AI068619 as part of the HPTN Scholars Program.

The authors have no conflicts of interest to disclose.

Received August 28, 2013

Accepted August 28, 2013

© 2014 by Lippincott Williams & Wilkins