Coatsworth Ashley M, Scheidell Joy D, Wohl David A, Whitehead Nicole E, Golin Carol E, Judon-Monk Selena, Khan Maria R
Department of Epidemiology, University of Florida, Gainesville, FL, USA.
Division of Comparative Effectiveness and Decision Science, Department of Population Health, New York University School of Medicine, New York, NY, USA.
J Urban Health. 2017 Feb;94(1):136-148. doi: 10.1007/s11524-016-0120-3.
We evaluated the association between social support received from significant others, family, and friends and HIV-related sexual risk behaviors among African American men involved in the criminal justice system. Project DISRUPT is a cohort study among African American men released from prison in North Carolina (N = 189). During the baseline (in-prison) survey, we assessed the amount of support men perceived they had received from significant others, family, and friends. We measured associations between low support from each source (<median value) and participants' sex risk in the 6 months before incarceration. Low levels of social support from significant others, family, or friends were associated with poverty and homelessness, mental disorders, and substance use. Adjusting for age, poverty, and other sources of support, perceiving low support from significant others was strongly associated with multiple partnerships (fully adjusted odds ratio (OR) 2.64, 95% confidence interval (CI) 1.29-5.42). Low significant other support also was strongly associated with sex trade involvement when adjusting for age and poverty status (adjusted OR 3.51, 95% CI 1.25-9.85) but further adjustment for low family and friend support weakened the association (fully adjusted OR 2.81, 95% CI 0.92-8.55). Significant other support was not associated with other sex risk outcomes including concurrent partnerships, anal sex, or sex with an STI/HIV-infected partner. Low family support was associated with multiple partnerships in analyses adjusting for age and poverty (adjusted OR 1.98, 95% CI 1.05-3.76) but the association weakened and was no longer significant after adjusting for other sources of support (fully adjusted OR 1.40, 95% CI 0.65-3.00); family support was not correlated with other risk behaviors. Friend support was not significantly associated with sex risk outcomes. Indicators of overall support from any source were not associated with sex risk outcomes. Helping inmates maintain ties may improve economic security and well-being during community re-entry, while supporting and strengthening relationships with a significant other in particular may help reduce sex risk. Studies should evaluate the protective effects of distinct support sources to avoid masking effects of support and to best understand the influence of social support on health.
我们评估了从重要他人、家人和朋友那里获得的社会支持与参与刑事司法系统的非裔美国男性中与艾滋病毒相关的性风险行为之间的关联。“破坏计划”是一项针对北卡罗来纳州出狱的非裔美国男性的队列研究（N = 189）。在基线（入狱时）调查中，我们评估了男性认为自己从重要他人、家人和朋友那里获得的支持量。我们测量了来自每个来源的低支持（<中位数）与参与者入狱前6个月内的性风险之间的关联。来自重要他人、家人或朋友的低水平社会支持与贫困、无家可归、精神障碍和物质使用有关。在调整年龄、贫困和其他支持来源后，认为从重要他人那里获得的支持较低与多重性伴侣关系密切相关（完全调整后的优势比（OR）为2.64，95%置信区间（CI）为1.29 - 5.42）。在调整年龄和贫困状况后，来自重要他人的低支持也与性交易参与密切相关（调整后的OR为3.51，95%CI为1.25 - 9.85），但进一步调整来自家人和朋友的低支持会削弱这种关联（完全调整后的OR为2.81，95%CI为0.92 - 8.55）。来自重要他人的支持与其他性风险结果无关，包括同时存在的性伴侣关系、肛交或与感染性传播感染/艾滋病毒的伴侣发生性行为。在调整年龄和贫困的分析中，来自家人的低支持与多重性伴侣关系有关（调整后的OR为1.98，95%CI为1.05 - 3.76），但在调整其他支持来源后，这种关联减弱且不再显著（完全调整后的OR为1.40，95%CI为0.65 - 3.00）；来自家人的支持与其他风险行为无关。来自朋友的支持与性风险结果无显著关联。来自任何来源的总体支持指标与性风险结果无关。帮助囚犯维持联系可能会改善社区重新融入期间的经济安全和幸福感，而特别支持和加强与重要他人的关系可能有助于降低性风险。研究应评估不同支持来源的保护作用，以避免支持的掩盖效应，并最好地理解社会支持对健康的影响。
