King Kelly M, Latkin Carl A, Davey-Rothwell Melissa A
Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21231, USA,
J Urban Health. 2015 Jun;92(3):460-71. doi: 10.1007/s11524-015-9951-6.
One out of nine African-American men between the ages of 20 and 34 is behind bars, resulting in many African-American women losing their primary romantic partners to incarceration. Research suggests that partner incarceration may contribute to increased risk of sexually transmitted infections (STIs)/human immunodeficiency virus (HIV); however, factors associated with women's decisions to begin new sexual partnerships following partner incarceration (i.e., separational concurrency) have not been well studied. This study examined the social context relevant to initiating separational concurrency, following incarceration of a primary male partner. Cross-sectional secondary data analysis of 6-month follow-up data from the CHAT Project, a social-network based HIV/sexually transmitted disease (STD) prevention study in Baltimore, MD, USA. Participants were N = 196 African-American women, who reported ever having had a partner who was incarcerated for at least 6 months during the relationship. The majority (81.5%) of women were unemployed with a mean age of 41.7 years. Over half of the sample (59.5%) reported having used crack or heroin at least once in the previous 12 months; 48.5% of the women had experienced physical abuse, with over half of the sample reporting a lifetime history of emotional abuse (54.6%). Separational concurrency, defined as answering yes to the item, "While [your] partner was incarcerated, did you have any other sexual partners?," was the primary outcome measure. After adjusting for age, drug use and unemployment the multiple logistic regression model found that women who reported a history of physical or emotional abuse were over two times as likely to report separational concurrency than women without an abuse history [adjusted odds ratio (AOR), 2.24; 95% CI, 1.24, 4.05; p = .007 and AOR, 2.44; 95% CI, 1.33, 4.46; p = .004, respectively]. Individuals who reported a higher number of drug-using sex partners (AOR, 2.49; 95% CI, 1.4, 4.5; p = .002), sex exchange partners (AOR, 4.0; 95% CI, 1.8 8.9; p = .001), and sexual partners who engaged in concurrency (AOR: 2.67; 95% CI: 1.5, 4.8; p = .001) were significantly more likely to report separational concurrency. Conversely, participants who reported more female kin in their social networks (AOR, .808; 95% CI, .67, .97; p = .025), having known network members a longer time (AOR, .997; 95% CI, .993, .999; p = .043), and higher levels of trust for network members (AOR, .761; 95% CI, .63, .92; p = .005) were significantly less likely to report separational concurrency. Results of this study demonstrate that social network characteristics may be crucial to understanding separational concurrency among African-American urban women who have lost a partner to incarceration. Social network and other resource-based interventions, which provide instrumental, social, and economic resources to women who have experienced the loss of a partner to incarceration, may be important tools in empowering women and helping to reduce the disproportionate burden of STIs/HIV among low income, African-American women.
在20至34岁的非裔美国男性中,每九人就有一人入狱,这导致许多非裔美国女性的主要浪漫伴侣因监禁而失去。研究表明,伴侣入狱可能会增加性传播感染(STIs)/人类免疫缺陷病毒(HIV)的风险;然而,与女性在伴侣入狱后开始新的性伴侣关系(即分居并发)的决定相关的因素尚未得到充分研究。本研究调查了与主要男性伴侣入狱后开始分居并发相关的社会背景。对来自美国马里兰州巴尔的摩市一项基于社交网络的HIV/性传播疾病(STD)预防研究CHAT项目的6个月随访数据进行横断面二次数据分析。参与者为N = 196名非裔美国女性,她们报告曾有过在恋爱关系中入狱至少6个月的伴侣。大多数(81.5%)女性失业,平均年龄为41.7岁。超过一半的样本(59.5%)报告在过去12个月中至少使用过一次强效可卡因或海洛因;48.5%的女性曾遭受身体虐待,超过一半的样本报告有过情感虐待史(54.6%)。分居并发的定义为对“当[你的]伴侣入狱时,你是否有过其他性伴侣?”这一问题回答“是”,这是主要的结局指标。在对年龄、药物使用和失业情况进行调整后,多元逻辑回归模型发现,报告有身体或情感虐待史的女性报告分居并发的可能性是没有虐待史女性的两倍多[调整后的优势比(AOR)为2.24;95%置信区间(CI)为1.24, 4.05;p = 0.007,AOR为2.44;95% CI为1.33, 4.46;p = 0.004]。报告有更多吸毒性伴侣(AOR为2.49;95% CI为1.4, 4.5;p = 0.002)、性交易伴侣(AOR为4.0;95% CI为1.8, 8.9;p = 0.001)以及有并发行为的性伴侣(AOR为2.67;95% CI为1.5, 4.8;p = 0.001)的个体报告分居并发的可能性显著更高。相反,报告在其社交网络中有更多女性亲属(AOR为0.808;95% CI为0.67, 0.97;p = 0.025)、认识网络成员时间更长(AOR为0.997;95% CI为0.993, 0.999;p = 0.043)以及对网络成员信任度更高(AOR为0.761;95% CI为0.63, 0.92;p = 0.005)的参与者报告分居并发的可能性显著更低。本研究结果表明,社交网络特征对于理解伴侣入狱的非裔美国城市女性中的分居并发情况可能至关重要。社交网络及其他基于资源的干预措施,为经历伴侣入狱的女性提供工具性、社会性和经济性资源,可能是增强女性权能以及帮助减轻低收入非裔美国女性中STIs/HIV不成比例负担的重要工具。