Relationship Between Incarceration Frequency and Human Immunodeficiency Virus Risk Behaviors of African American Inmates by ProQuest


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Relationship Between Incarceration Frequency
and Human Immunodeficiency Virus Risk
Behaviors of African American Inmates
Titilayo C. Abiona, MD, FMCPH; Adedeji S. Adefuye, MD, MPH, FRIPH; Joseph A. Balogun, PT, PhD, FACSM;
Patricia E. Sloan, EdD, RN, FAAN

  Funding/Support: This research was supported by a grant                       IntroduCtIon

  from the Illinois General Assembly and the Illinois Depart-                           ompared with other racial groups, African
  ment of Public Health.                                                                Americans are disproportionately affected by
                                                                                        the human immunodeficiency virus (HIV) and
  disclaimer: The information or content and conclusions are                    AIDS. Although they make up only 12% of the US
  those of the authors and should not be construed as the                       population, African Americans accounted for 45%
  official position or policy of, nor should any endorsement                    of all HIV/AIDS cases diagnosed in 2006, compared
  be inferred by the Illinois General Assembly and the Illinois                 with 17% for Hispanics and 35% for whites.1 HIV inci-
  Department of Public Health.                                                  dence rate was 7 times as high among blacks as among
  Objective: We examined the relationship between frequen-                      whites.1 In the same year, blacks represented about half
  cy of incarceration and preincarceration risk behaviors and                   (46%) of all cases of HIV in the United States, and the
  determined the demographic factors associated with risk                       HIV prevalence rates were 1715 per 100 000 among
  behaviors among a sample of African American inmates.                         blacks, 585.3 per 100 000 among Hispanics, and 224.3
                                                                                per 100 000 among whites. 2 The HIV prevalence rate
  Methods: We surveyed 229 (102 female and 127 male) ran-
                                                                                among African American men was 6 times the rate among
  domly selected inmates. Risk behaviors between inmates
                                                                                white men (2388 per 100 000 vs 395 per 100 000), and
  serving their first prison sentence and those who had been
                                                                                the prevalence rate among African American women was
  incarcerated in prison more than once were compared
                                                                                18 times the rate among white women (1122 per 100 000
  using the c2 test. Multivariate logistic regression analysis was
                                                                                vs 63 per 100 000).3 The disproportional higher rates of
  used to determine factors associated with risk behaviors.
                                                                                HIV/AIDS is even more alarming among young blacks;
  Results: For most risk behaviors, there were no significant dif-              11 554 (61%) of the estimated 18 849 people under the
  ferences between inmates serving their first prison sentence                  age of 25 years diagnosed of HIV/AIDS between 2001
  and inmates incarcerated more than once; however, male                        and 2004 were black.4 For AIDS specifically, in 2005,
  inmates who had been incarcerated more than once were                         the rates of diagnoses for black adults and adolescents
  more likely to report having had multiple vaginal sex partners                were 10 times the rates for whites and 3 times the rate
  (OR, 2.42; 95% CI, 1.10-5.32; P = .03). No demographic variable               for Hispanics. Similarly, the rate of AIDS diagnoses for
  was found to be independently associated with risk behaviors.                 black women was almost 23 times that of white women;
  Conclusions: Frequency of incarceration did not affect                        and for black men, it was 8 times that of white men.5
  preincarceration human immunodeficiency virus (HIV) risk                          The male and female incarcerated population in the
  behaviors among this sample of African American inmates.                      United States has increased greatly within the last 2
  HIV prevention efforts should be directed at addressing the                   decades largely due to drug policy.6,7 This increase is
  individual and structural factors associated with high-risk                   greatest within the African American population. Com-
  behaviors among African Americans.                                            pared to 1984, when the rate of incarceration of African
                                                                                American men was 1 in 30, in 1997, the proportion of
  Keywords: risk behaviors n HIV/AIDS n African Americans                       African America
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