Male incarceration and women's sexual health: A comparative qualitative study among heterosexual African-American women

Background: Areas with high incarceration rates have high rates of HIV and other sexually transmitted infections (STIs). Few studies have explored mechanisms linking incarceration rates to HIV/STI rates. The goal of this study was to examine and compare the processes through which male incarceration and resulting imbalanced male:female sex ratios in two neighborhoods influence the formation and maintenance of sexual partnerships among heterosexual African-American women.

Methods: This qualitative study consisted of semi-structured interviews with 40 heterosexual African-American women living in two neighborhoods: one with a high rate of incarceration and a low male:female sex ratio and one with lower incarceration rate and sex ratio close to 1.00. Interviews covered several topics, including perceptions of local male incarceration, sex ratios, and relationships. Interviews were transcribed verbatim. Data were analyzed using grounded theory methods.

Results: Preliminary results suggest that neighborhood rates of male incarceration influenced participants' partnerships by affecting the availability of desirable male partners. In the census tract with a lower rate of incarceration other factors (e.g. men being married) contributed to a reduced number of available men. The number of available men (either shaped by incarceration or marital status) had an impact on the commitment and purpose of partnerships and the participant's sexual decision-making; many women were unable to negotiate safer sex practices with their partners.

Conclusion: This study illuminates pathways through which high incarceration and the number of available men produce vulnerability to STI/HIV among African-American women. Risk-reduction interventions targeting this group should consider the number of available men.