HIV and HCV prevalence and sexual risk behaviors among women with criminal justice system involvement

Background: Criminal-justice involved women are at increased risk for HIV and other infectious diseases. To inform interventions designed to reduce HIV transmission risk behaviors in this population, we describe sexual behaviors, associated social and contextual risk factors, and HIV and HCV prevalence.

Methods: As part of a SAMHSA-funded program designed to promote testing, education, and care linkages among criminal-justice involved women in New York City, 175 women completed a baseline self-report ACASI survey and were tested for HIV and HCV infection between 6/07-9/09.

Results: Respondent mean age was 43; 57% were African American and 23% Latina; 63% had less than 10K annual income. In the last 3 months, nearly half were homeless (48%), 19% used illicit drugs, 30% were married or living with a partner and 37% reported physical partner abuse. Twenty six percent had unprotected sex in exchange for money, drugs, or shelter, with an IDU, or with someone with suspected HIV/STD infection; 24% were positive for HIV (6%) or HCV (16%). Higher-risk sex was reported in 27% of women with HIV/HCV infection, and 19% without infection (p=.29). In a logistic regression model including age, drug use, relationship status, housing, income, and abuse, lower income (OR 1.5) and drug use (OR 5.3) were associated with high-risk sexual behavior (both p < .05).

Conclusions: This sample had high rates of HIV/HCV infection, homelessness, domestic abuse, and high-risk sexual behavior. Poverty and drug use were associated with high-risk sexual behavior, although differences between risk behavior and HIV/HCV status were not detected.