Substance use and HIV-risk behaviors among young men involved in the criminal justice system (original) (raw)
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AIDS and behavior, 2003
Ninety-seven service providers, representing 83 agencies, were interviewed about sexual and drug use HIV/STD risk behaviors and their determinants among young men who have been released from prison. Providers believed that men frequently practiced sexual risk behavior, often in conjunction with substance use. Individual determinants of risk behavior primarily focused on "making up for lost time," being a man, degree of HIV/STD knowledge and vulnerability, desire to escape, and future orientation. Peers, partners, and family were portrayed as strong interpersonal influences on risk behavior, both positively and negatively. The dominant contextual determinant of risk behavior was the co-occurrence of sex and drug use. Structural determinants of reduced risk included stable housing, economic sufficiency, and positive community support for safer behavior (e.g., drug treatment access, needle exchange). The findings highlight the need for comprehensive, transitional case managem...
Addictive Behaviors, 2004
Inmates report use of a wide range of drugs including heroin, methadone, and cocaine at some point in their lives without a doctor's prescription. The most commonly used drugs include marijuana and cocaine; tobacco and alcohol are also widely used [Am. J. Public Health 90 (2000) 1939; Am. J. Drug Alcohol Abuse 26 (2000) 229]. The present study explores the relationship between marijuana use and prior incarceration on 208 inmates' self-reported HIV/AIDS risk behaviors. Analysis involved descriptive and chi-square tests of association. Findings indicate that inmates with higher self-reported levels of education were significantly less likely than others to be repeat offenders. Data also support the argument that income prior to the most recent arrest and frequency of marijuana use was related to the outcome of being a repeat offender.
Journal of Urban Health, 2010
Although criminal justice involvement has repeatedly been associated with human immunodeficiency virus (HIV)/sexually transmitted infection prevalence and sexual risk behaviors, few studies have examined whether arrest or incarceration uniquely contributes to sexually risky behavior. We examined the temporal relationship between criminal justice involvement and subsequent sexual HIV risk among men in methadone maintenance treatment in New York City. A random sample of 356 men was interviewed at baseline (time 1), 6-month (time 2), and 12-month (time 3) followups. Propensity score matching, negative binomial, and multiple logistic regression were used to isolate and test the effect of time 2 arrest and incarceration on time 3 sexual risk behaviors. Incidence of time 2 criminal justice involvement was 20.1% for arrest and 9.4% for incarceration in the prior 6 months. Men who were arrested at time 2 demonstrated increased number (adjusted incidence rate ratio [IRR]=1.62; 95% confidence intervals [CI]=1.11, 2.37) and proportion (IRR=1.36; 95% CI=1.07, 1.72) of unprotected vaginal sex acts at time 3. Men incarcerated at time 2 displayed increased number (IRR=2.07; 95% CI=1.23, 3.48) and proportion (IRR=1.45; 95% CI=1.06, 1.99) of unprotected vaginal sex acts at time 3. Within this sample of druginvolved men, arrest and incarceration are temporally associated with and may uniquely impact successive sexual risk-taking. Findings underscore the importance of HIV prevention interventions among individuals with low-intensity criminal justice involvement. Developing prevention efforts aimed at short-term incarceration, community reentry, and alternatives to incarceration settings will address a large and underresearched segment of the criminal justice population. Alternative approaches to current criminal justice policy may result in public health benefits.
Co-Occurring Sexual Risk and Substance Use Behaviors Among Incarcerated Adolescents
Journal of correctional health care : the official journal of the National Commission on Correctional Health Care, 2006
Incarcerated adolescents report greater sexual risk than do nonincarcerated peers. High-risk sexual behavior is associated with substance use. To determine how much sexual risk is combined with substance use, 167 incarcerated adolescents reported on their sexual risk behavior in the year before incarceration that involved alcohol or marijuana. For each risk behavior, marijuana use was more likely than was alcohol use. Marijuana use was more common for higher risk behaviors than for lower risk behaviors. Periods of incarceration provide opportunities for intervening on HIV-relevant risk behaviors among adolescents. The context of substance use within high-risk sexual situations ought to be a focus of interventions for incarcerated adolescents.
Culture, Health & Sexuality, 2012
This study investigated the role of incarceration in HIV/STD risk among 197 Black men who have sex with men in Massachusetts, USA. More than half (51%) reported a history of incarceration (28% , 90 days in jail/prison; 23% $ 90 days in jail/prison). Multivariable logistic regression models adjusted for age and sexual orientation examined associations between demographic, behavioural, social-psychological and cultural factors and incarceration history. Factors associated with , 90 days of incarceration were: unprotected sex with a man, STD history, injection drug use and substance abuse treatment. Factors associated with $ 90 days of incarceration were: unprotected sex with a woman, crack use during sex, STD history, injection drug use, substance abuse treatment, depressive symptoms, post-traumatic stress symptoms, HIV fatalism and social capital. Black men who have sex with men with incarceration histories may be at increased risk for HIV/STDs compared to those without such histories. HIV prevention efforts that focus on individual risk and cultural-contextual issues among Black men who have sex with men are warranted.
Predicting HIV/STD Risk Level and Substance Use Disorders Among Incarcerated AdolescentsĈ
Journal of Psychoactive Drugs, 2008
Incarcerated adolescents are among the most vulnerable groups for STD infection, and substance abuse is prevalent in over half of this population. Substance abuse and HIV/STD-associated risk behaviors are closely linked among juvenile justice-involved youth, but it Is unclear whether common antecedents explain these different problems. The current study examined predictors of HIV/STD risk level and substance use disorders, and investigated whether family variables added unique predictive variance for these problems among incarcerated youth. The sample included 154 substance-involved youth ages 13 to 17 recruited in detention facilities in Miami and Tampa, PL and was primarily male (82%) and African-American (58%). Using a comprehensive assessment strategy with data obtained from youth report, parent report, and laboratory confirmed STD testing, the results show that delinquency is a consistent predictor of both HTV/STD risk level and substance use disorders, and also that substance use directly predicts HIV/STD risk level among incarcerated adolescents. Consistent with previous research, family conflict is an important predictor of substance use disorders even after controlling for other factors. The results suggest the need for integrated family-based interventions addressing delinquency, substance abuse, and HIV/STD-associated risk factors with juvenile justice-involved adolescents.
The Prison Journal, 2004
AIDS was first identified among prison inmates in 1983. In 2001, the rate of confirmed cases of HIV infection was four times greater among federal and state prison inmates than in the general population. This study used extensive interviews to assess Illinois prison inmates' sexual and drug use practices, their knowledge about HIV risk reduction techniques, and their beliefs regarding their own HIV risk status and their ability to avoid HIV infection. Respondents were classified into risk groups based on their sexual and drug use behaviors prior to incarceration. Compared with those in the low-risk group, respondents in the high-risk group were more likely to have used or sold drugs and to have lower self-efficacy and perceived-risk scores. Respondents in the moderate-risk group were more likely than those in the low-risk group to be young, to have sold drugs, and to have lower self-efficacy scores. The implications of these differences for HIV prevention programs tailored by risk profile are discussed.
AIDS Care, 2015
The U.S. HIV/AIDS epidemic is concentrated among men who have sex with men (MSM). Black men are disproportionately affected by incarceration and Black MSM experience higher infection rates and worse HIV-related health outcomes compared to non-Black MSM. We compared HIV treatment outcomes for Black MSM to other HIV-infected men from one of the largest cohorts of HIV-infected jail detainees (N=1,270) transitioning to the community. Of the 574 HIV-infected men released, 113 (19.7%) self-identified as being MSM. Compared to other male subgroups, young Black MSM (<30 years old, N=18) were significantly less likely: 1) before incarceration, to have insurance, access to a HIV healthcare provider, and use cocaine; 2) during incarceration, to receive a disease management intervention; and 3) in the 6 months post-release, to link to HIV care. Interventions that effectively link and retain young HIV-infected Black MSM in care in communities before incarceration and post-release from jail are urgently needed.
Alcohol Use and HIV Risk Among Juvenile Drug Court Offenders
Journal of Social Work Practice in the Addictions, 2012
Juvenile drug courts (JDC) largely focus on marijuana and other drug use interventions. Yet, JDC offenders engage in other high-risk behaviors, such as alcohol use and sexual risk behaviors, which can compromise their health, safety and drug court success. An examination of alcohol use and sexual risk behaviors among 52 male substance abusing young offenders found that over 50% were using alcohol, 37% reported current marijuana use and one-third of all sexual intercourse episodes were unprotected. After accounting for recent marijuana use, the odds of a juvenile having vaginal or anal sex was 6 times greater if they had recently used alcohol. Juvenile drug courts may benefit from delivering alcohol and sexual risk reduction interventions to fully address the needs of these young offenders.
Substance use & misuse, 2016
Young Black men who have sex with men (YBMSM) are at highest risk for HIV seroconversion in the United States. Successful movement through the HIV care continuum is an important intervention for limiting onwards HIV transmission. Little data exists on how substances most commonly used by YBMSM, such as marijuana, are related to the HIV continuum, which represents the primary aim of this study. A cohort of YBMSM (n = 618) was generated through respondent-driven sampling. Frequency of marijuana use and marijuana use as a sex-drug were assessed across the HIV care continuum using weighted logistic regression models. Study participants reported more intermittent marijuana use (n = 254, 56.2%) compared to heavy use (n = 198, 43.8%). Our sample contained 212 (34.3%) HIV seropositive participants of which 52 (24.5%) were unaware of their HIV positive status. Study participants who were heavy marijuana users were more likely to be unaware of their HIV seropositive status (AOR: 4.18; 95% CI ...