Incarceration and HIV: Examining the relationship between incarceration and sexual risk

Background: Among African American men, 1 in 5 of those infected with HIV were incarcerated at some point in 2006. Prior research has found associations between incarceration and HIV as well as between incarceration and high numbers of sexual partners and concurrent partners, both established HIV risk factors. The growing evidence for a connection between incarceration and sexual risk necessitates exploration of how and when incarcerated men diverge from similar men who have never been incarcerated in terms of sexual decision-making. Objectives: This study has two overarching objectives. The first is to determine whether men who will later be incarcerated differ from those who will not be incarcerated in terms of sexual decision-making, and sexual behavior even before they are incarcerated. The second is to evaluate the effects of incarceration on sexual behavior variables and to examine whether there is a differential effect of incarceration by race. Methods: This study will use Waves II and III of the National Longitudinal Study of Adolescent Health (Add Health), a school-based longitudinal study of a nationally-representative sample of adolescents in the United States; the analysis will be limited to male respondents. The multivariable analysis will consist of two sets of regression models of number of sexual partners (past 12 months and lifetime) and rates of concurrency on a history of incarceration. The first analysis will estimate whether future incarceration (Wave III) predicts number of sexual partners and rates of concurrency in Wave II (an earlier time point), and the second will determine the effect of past incarceration (Wave III) on the dependent variables observed in Wave III. Results: The results of this study will include a comparison of the sexual behaviors of those who will later be incarcerated, with men who do not progress to incarceration, in order to determine whether, and to what extent, differences in sexual behavior exist prior to experience of incarceration. The study will also produce a more precise estimate of the effect of incarceration on sexual behaviors, including number of sexual partners and rates of concurrency, both known risk factors for HIV.