Gendered identity of HIV positive formerly incarcerated males: The tension between imposed masculinity and perceived femininity

The incarceration rate has risen steeply in the United States over the last decades, with the rate from 1980 to 2010 increasing by 323%. Those most at risk of becoming incarcerated, such as substance users and African Americans, are similarly at increased risk of becoming HIV positive. The rate of HIV among those who are incarcerated is estimated to be 4 to 6 times higher than the prevalence rate in the general U.S. population, and those who are incarcerated are also at increased risk of experiencing mental illness, substance use, other sexually transmitted diseases, and socially marginalizing conditions such as homelessness, victimization, and poverty. However, an understudied element of the intersection of HIV and incarceration is the investigation of how the decidedly masculine incarceration environment and the perceived femininity of HIV positive individuals creates identity tension within HIV positive incarcerated populations. Research has shown that incarcerated populations are less likely to endorse gay identities but limited research has explored the ways in which HIV positive individuals navigate this tension. Therefore, this research study explores this tension and how it affects community reintegration post-release from prison or jail and how HIV positive individuals report it affects their health. Twelve African American HIV positive males engaged in a series of ethnographic interviews and observations (N=75) over a period of one year. Our findings show that participants often reported that the prison or jail environment had negatively influenced their ability successfully reintegrate into their community and that they often felt as if others transposed their stereotypes of both "formerly incarcerated individuals" and "HIV positive" and that these opposing identities were often at odds. These findings have implications for programs and intervention programs that target HIV positive formerly incarcerated individuals.