Criminal justice involvement and associated HIV risk among men on methadone

Background: Past research shows increased HIV risk and prevalence for men in the criminal justice system, which is often attributed to high levels of substance abuse in this population. This study examines the relationship between HIV risk indicators and criminal justice involvement in a random sample of 356 men in methadone maintenance treatment programs, in order to develop a better understanding of the specific risks faced by this group.

Methods: Bivariate analyses were performed to examine demographic and HIV-risk behavior differences between men with and without recent criminal justice involvement. Logistic regression was used to estimate associations between measures of criminal justice involvement and participant HIV risk, controlling for socio-demographic variables.

Results: In the six months prior to assessment, 26% of the sample had been arrested and 11% were incarcerated. A lifetime history of incarceration was significantly associated with being HIV positive (Adjusted OR=5.93, p<.001). Recent arrest was associated with unprotected vaginal sex (Adjusted OR=2.17, p<.01) as well as having multiple sexual partners. Sex trading was strongly associated with both recent arrest and incarceration (OR = 3.18, p<.05). Recent injection drug use was also associated with recent arrest and incarceration.

Conclusion: Findings suggest that criminal justice involvement increases the risk of HIV among men with substance abuse histories, and the heightened risk is not explained by demographics or current substance use. The results underscore the need for targeted HIV prevention efforts for men on methadone with a recent history of arrest or incarceration.