ABSTRACT
The USA currently has the highest incarceration rate in the world. Individuals at greatest risk for HIV also tend to be among those at an elevated risk for incarceration. The HIV epidemic is driven by injection drug use and sexual behaviour, and estimates of prison-based sexual behaviour vary widely. This study examined sexual behaviour among 1369 incarcerated men and women in the New York City area. Approximately 13% of the sample (n = 176) reported being sexually active while incarcerated over the previous 6 months. Multiple logistic regression models were used to examine the predictors of prison sexual behaviour. The following variables were associated with increased odds of sexual activity in the previous six months: female gender (OR = 3.28; 95%CI = 1.95,5.51), Black race (OR = 2.26; 95%CI = 1.47,3.46), history of drug use (OR = 1.85; 95%CI = 1.04,3.30), bisexual (OR = 3.19; 95%CI = 1.90,5.38) or homosexual identity (OR = 8.50; 95%CI = 3.92,18.43) and conjugal visitation programme participation (OR = 66.26; 95%CI = 31.42,139.74). Educational programmes regarding sexually transmitted infections and appropriate harm reduction measures are warranted for this population. The expansion of conjugal visitation programmes may also be useful in helping prisoners sustain their relationships with partners from their community and reduce the risk of infectious disease transmission in this environment.
ABSTRACT
BACKGROUND: The United States of America currently has the highest incarceration rate in the world, and approximately 80% of incarcerated individuals have a history of illicit drug use. Despite institutional prohibitions, drug use continues in prison, and is associated with a range of negative outcomes. OBJECTIVES: To assess the relationship between prison drug use, duration of incarceration, and a range of covariates. RESULTS: Most participants self-reported a history of illicit drug use (77.5%). Seven percent reportedly used drugs during the previous six months of incarceration (n = 100). Participants who had been incarcerated for more than a year were less likely than those incarcerated for longer than a year to report using drugs (OR = 0.50; 95% CI = 0.26-0.98). Participants aged 37-89 were less likely than younger prisoners to use drugs (OR = 0.39; 95% CI = 0.19-0.80). Heroin users were twice as likely as nonheroin users to use drugs (OR = 2.28; 95% CI = 1.04-5.03); crack cocaine users were also twice as likely as participants with no history of crack cocaine usage to report drug use (OR = 2.53; 95% CI = 1.13-5.69). CONCLUSIONS: Correctional institutions should be used as a resource to offer evidence-based services to curb drug usage. Drug treatment programs for younger prisoners, heroin and crack cocaine users, and at the beginning of a prisoner's sentence should be considered for this population.
