Incarceration among HIV-infected and at-risk women in the U.S
assess the impact on mortality.
Method: We used logistic regression and cox proportional-hazards regression to determine factors
associated with incarceration and mortality among women enrolled in the Women’s Interagency HIV
Study with data collected between 2007 and 2014.
Results: Among 2520 women (HIV+1798/HIV-722, 59% African-American, median age 44 years (IQR: 38-
50)), 37% reported incarceration; of those, 29% were incarcerated once; 43% reported 2-5
incarcerations; 28% reported > 5 incarcerations. Median days in jail per incarceration was 10 (IQR: 2-
60). HIV-infected women did not continue HIV medications during 42% of incarceration periods. Factors
associated with incarceration included less than high school education (aOR 1.43, 95%CI 1.10-1.87),
unemployment (aOR 1.44, 95%CI 1.14-1.81), unstable housing (aOR 1.93, 95%CI 1.47-2.53),
crack/cocaine/heroin use (aOR 1.88, 95%CI 1.47-2.42), injection drug use (aOR 1.63, 95%CI 1.06-2.50),
transactional sex (aOR 3.17, 95%CI 2.53-3.97), and Hepatitis C (aOR 2.16, 95%CI 1.66-2.81). HIV status
was not significantly associated with incarceration (aOR 0.93, 95%CI 0.73-1.18). Survival time was
significantly shorter for HIV-infected women who were incarcerated compared to women who were not
incarcerated (cHR, 2.53, 95%CI 1.7-3.7). This association was attenuated after adjusting for age,
Hepatitis C, CD4 count and viral load (aHR 1.59, 95%CI 0.97-2.59).
Conclusion: Incarceration has negative impact on the health and quality of life of women with and at-
risk for HIV and strategies to reduce incarceration rates should be pursued.
Public health or related public policy
Social and behavioral sciences
Identify factors associated with incarceration among a cohort of HIV infected and at-risk women and assess the impact of incarceration on mortality.
Keyword(s): HIV/AIDS, Criminal Justice
Qualified on the content I am responsible for because: I have been the PI on the WIHS in Chicago since 1994 and have reviewed all the data in this presentation.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.