Wise Akilah, Finlayson Teresa, Nerlander Lina, Sionean Catlainn, Paz-Bailey Gabriela
Division of HIV/AIDS Prevention, National Center for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA.
J Acquir Immune Defic Syndr. 2017 Jul 1;75 Suppl 3:S261-S267. doi: 10.1097/QAI.0000000000001401.
Women involved in the criminal justice system experience multiple risk factors that increase the likelihood of acquiring HIV infection. We evaluated the prevalence of incarceration and compared behaviors among women with and without an incarceration history.
We use the 2013 National HIV Behavioral Surveillance data, which uses respondent-driven sampling. We evaluate the association between incarceration and the following past 12 months outcomes: exchange sex, multiple casual sex partners (≥3), multiple condomless sex partners (≥3), HIV test, and sexually transmitted infection diagnoses. Log-linked Poisson regression models, adjusted for demographics and clustered on city, with generalized estimating equations were used to estimate adjusted prevalence ratios (aPRs) and 95% confidence intervals.
Of 5154 women, 11% were incarcerated within the previous year, 36% were ever incarcerated but not in the past 12 months, and 53% were never incarcerated. Prevalence of exchange sex (aPR 1.32, 1.20-1.46), multiple casual partners (aPR 1.59, 1.2-2.1), multiple casual condomless partners (aPR 1.47, 1.07-2.03), and sexually transmitted infection diagnosis (aPR 1.61, 1.34-1.93) were all higher among recently incarcerated women compared with those never incarcerated. We also found higher prevalence of recent HIV testing among women recently incarcerated (aPR 1.30, 1.18-1.43).
Nearly half of women in our study had been incarcerated. Recent incarceration was associated with several factors that increase the risk of HIV acquisition. HIV prevention, testing, and early treatment among women with a history of incarceration can maximize the effectiveness of the public health response to the HIV epidemic.
参与刑事司法系统的女性面临多种风险因素，这些因素增加了感染艾滋病毒的可能性。我们评估了监禁的患病率，并比较了有监禁史和无监禁史女性的行为。
我们使用2013年全国艾滋病毒行为监测数据，该数据采用应答者驱动抽样。我们评估监禁与以下过去12个月结果之间的关联：性交易、多个临时性伴侣（≥3个）、多个无保护性行为伴侣（≥3个）、艾滋病毒检测和性传播感染诊断。使用对数链接泊松回归模型，对人口统计学进行调整并按城市聚类，采用广义估计方程来估计调整后的患病率比（aPRs）和95%置信区间。
在5154名女性中，11%在过去一年被监禁，36%曾被监禁但在过去12个月内没有，53%从未被监禁。与从未被监禁的女性相比，最近被监禁的女性中性交易（aPR 1.32，1.20 - 1.46）、多个临时性伴侣（aPR 1.59，1.2 - 2.1）、多个无保护性行为临时性伴侣（aPR 1.47，1.07 - 2.03）以及性传播感染诊断（aPR 1.61，1.34 - 1.93）的患病率均更高。我们还发现最近被监禁的女性中近期艾滋病毒检测的患病率更高（aPR 1.30，1.18 - 1.43）。
我们研究中近一半的女性曾被监禁。近期监禁与多种增加感染艾滋病毒风险的因素相关。对有监禁史的女性进行艾滋病毒预防、检测和早期治疗，可以最大限度地提高公共卫生应对艾滋病毒流行的有效性。
