Background Racial/ethnic and sexual minorities face elevated risk of policing and detainment. Dual minority status is linked to disproportionate incarceration; among black men who have sex with men (BMSM) in the HIV Prevention Trials Network (HPTN) study, 60% had been incarcerated. Incarceration disrupts networks and increases partnership exchange and STI. We lack understanding of the impact of incarceration on STI risk among BMSM.
Methods We used data from HPTN 061 (N=1553) conducted in Atlanta, Boston, New York, Los Angeles, San Francisco, and Washington DC to measure longitudinal associations between incarceration within six months and twelve-month risk of multiple partnerships and biologically-confirmed STI (gonorrhea, chlamydia, syphilis). Using inverse probability of treatment weighted (IPTW) regression to account for pre-incarceration poverty, psychopathology, drug use, and STI risk, we estimated risk ratios (RRs) and 95% confidence intervals (CIs) for associations between incarceration and outcomes and assessed differences by city.
Results Approximately 14% had been incarcerated in the past six months. Controlling for site, incarceration predicted multiple partnerships (RR: 1.20, 95% CI: 1.06–1.36) and incident STI (RR: 1.08, 95% CI: 1.00–1.16). Associations with multiple partnerships and STI differed by city (joint test of interaction, p value <0.05). Incarceration was most strongly associated with multiple partnerships (RR: 1.69, 95% CI: 1.38–2.04) and STI (RR: 1.31, 95% CI: 1.04–1.64) in Washington DC. In other cities, STI RRs ranged from 0.95 to 1.08 and were not significant at the 0.05 level. Incarceration was associated with multiple partnerships in New York (RR: 1.25, 95% CI: 1.01–1.55) and Boston (RR: 1.31, 95% CI: 1.08–1.58), while RRs ranged from 0.87 to 1.08 and were not significant in other cities.
Conclusion Recent incarceration impacts STI risk among BMSM in Washington DC and the northeastern United States.
Disclosure No significant relationships.
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