Dauria Emily F, Elifson Kirk, Arriola Kimberly Jacob, Wingood Gina, Cooper Hannah L F
From the *Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, RIUSA; †Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Atlanta, GA.
Sex Transm Dis. 2015 Jun;42(6):324-8. doi: 10.1097/OLQ.0000000000000268.
In the United States, rates of certain sexually transmitted infections (STIs) are increasing. Contextual factors seem to play an important role in shaping STI transmission dynamics. This longitudinal study explores the relationship between one contextual determinant of health (the male incarceration rate) and rates of newly diagnosed STIs in census tracts in Atlanta, GA.
The sample consisted of all census tracts in Atlanta (n = 946). Annual data on STI diagnoses were drawn from the Georgia surveillance system for 2005 to 2010; annual male incarceration data were drawn from the Georgia Department of Corrections for 2005 to 2010; and data on potential confounders were drawn from the US Census. Multivariable growth models were used to examine the association between the male incarceration rate and rates of newly diagnosed STIs, controlling for covariates.
Census tracts with higher baseline male incarceration rates had a higher baseline rate of newly diagnosed STIs. Census tracts with increasing male incarceration rates experienced a more rapid increase in their rate of newly diagnosed STIs. Census tracts with medium and high baseline male incarceration rates experienced a decrease in their rate of newly diagnosed STIs over time.
The present study strengthens the evidence that male incarceration rates have negative consequences on sexual health outcomes, although the relationship may be more nuanced than originally thought. Future multilevel research should explore individual sexual risk behaviors and networks in the context of high male incarceration rates to better understand how male incarceration shapes rates of STIs.
在美国，某些性传播感染（STIs）的发病率正在上升。背景因素似乎在塑造性传播感染的传播动态中起着重要作用。这项纵向研究探讨了一个健康背景决定因素（男性监禁率）与佐治亚州亚特兰大普查区新诊断性传播感染发病率之间的关系。
样本包括亚特兰大的所有普查区（n = 946）。2005年至2010年性传播感染诊断的年度数据来自佐治亚州监测系统；2005年至2010年男性年度监禁数据来自佐治亚州惩教部；潜在混杂因素的数据来自美国人口普查。使用多变量增长模型来检验男性监禁率与新诊断性传播感染发病率之间的关联，并对协变量进行控制。
基线男性监禁率较高的普查区新诊断性传播感染的基线发病率较高。男性监禁率上升的普查区新诊断性传播感染的发病率增长更快。基线男性监禁率处于中等和较高水平的普查区，其新诊断性传播感染的发病率随时间下降。
本研究强化了这样的证据，即男性监禁率对性健康结果有负面影响，尽管这种关系可能比最初认为的更为微妙。未来的多层次研究应在男性监禁率较高的背景下探索个体性风险行为和网络，以更好地理解男性监禁如何影响性传播感染的发病率。
