Incarceration and concurrency: Lessons from a mixed methods study of recently released inmates in Connecticut

Background: Considerable research suggests that concurrency increases HIV risk and transmission, and research has consistently and significantly identified incarceration as one of the factors associated with concurrency. This paper examines mechanisms through which this association may occur.

Methods: Data are from a mixed methods study of people recently released from prison onto parole and probation in New Haven, CT. The study included longitudinal semi-structured qualitative interviews (n=48) and a cross-sectional survey (n=130).

Results: Interview respondents were 70% male; survey respondents were 81% male. Among male survey respondents, both before and after their most recent incarceration, 32% of those in a committed relationship reported having concurrent sex partners. Among women in committed relationships, none before and 40% after incarceration reported additional sex partners. Among men with any sex partners, 54% before and 45% after incarceration reported more than one partner. For women, the comparable numbers were 36% and 44%.

Qualitative interviews revealed four major factors associated with concurrency: non-incarcerated partners begin new sexual relationships during the separation of incarceration that continue when the incarcerated partner is released; women in communities with many incarcerated men feel they cannot enforce monogamy; certain types of relationships provide privileged access to sex partners such that concurrency is not “cheating;” drug policy can produce concurrency.

Conclusions: There are a number of ways that incarceration may produce concurrency. Analysis of this relatively small sample suggests that the association of concurrency with incarceration may be even greater for women than for men.