Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, 722 West 168th Street, Floor 5, Room 536, New York, NY, 10032, USA.
Department of Public Health Education, University of North Carolina Greensboro, Greensboro, NC, USA.
J Urban Health. 2018 Aug;95(4):576-583. doi: 10.1007/s11524-018-0247-5.
Criminal justice practices in the USA disproportionately affect sexual and racial/ethnic minority men, who are at higher risk of incarceration. Previous research demonstrates associations between incarceration and sexual risk behaviors for men who have sex with men (MSM). However, little of this work focuses on young MSM (YMSM), particularly HIV-infected YMSM, despite nearly one-third reporting engagement in sexual risk behaviors, such as transactional sex. We therefore explored the association between incarceration and transactional sex among HIV-infected YMSM. We recruited 97 HIV-infected YMSM across 14 clinical sites in urban centers from August 2015 to February 2016. We used multivariate logistic regression to examine the relationship between incarceration and transactional sex among YMSM. The majority was 24 years old (78%) and racial/ethnic minority (95%); over half were not in school and reported an annual income of < $12,000. In the multivariate model, having ever been incarcerated (aOR = 3.20; 95% CI 1.07-9.63) was independently associated with a history of transactional sex. Being 24 years vs. younger (aOR = 9.68; 95% CI 1.42-65.78) and having ever been homeless (aOR = 3.71, 95% CI 1.18-11.65) also remained independently associated with a history of transactional sex. This analysis fills a gap in the literature by examining the relationship between incarceration and transactional sex among HIV-infected YMSM. Facilitating youths' engagement with social services available in their HIV clinic may serve as a key strategy in promoting health. Public health efforts need to address social-structural factors driving disproportionate rates of arrest and incarceration and related harms among this population.
美国的刑事司法实践不成比例地影响到性少数群体和种族/族裔少数群体男性，他们被监禁的风险更高。先前的研究表明，监禁与男男性行为者（MSM）的性风险行为之间存在关联。然而，这项工作很少关注年轻的男男性行为者（YMSM），尤其是感染艾滋病毒的 YMSM，尽管近三分之一的人报告有性行为风险行为，如交易性性行为。因此，我们探讨了感染艾滋病毒的 YMSM 中监禁与交易性性行为之间的关联。我们于 2015 年 8 月至 2016 年 2 月在城市中心的 14 个临床地点招募了 97 名感染艾滋病毒的 YMSM。我们使用多变量逻辑回归来检查 YMSM 中监禁与交易性性行为之间的关系。大多数参与者年龄为 24 岁（78%），为种族/族裔少数群体（95%）；超过一半的人不在上学，年收入低于 12000 美元。在多变量模型中，曾经被监禁（优势比[aOR]=3.20；95%置信区间[CI]1.07-9.63）与交易性性行为史独立相关。与 24 岁以下（aOR=9.68；95%CI 1.42-65.78）和曾经无家可归（aOR=3.71，95%CI 1.18-11.65）的人相比，也与交易性性行为史独立相关。这项分析通过检查感染艾滋病毒的 YMSM 中监禁与交易性性行为之间的关系，填补了文献中的空白。促进青少年参与他们的艾滋病毒诊所提供的社会服务，可以成为促进健康的关键策略。公共卫生工作需要解决导致这一人群被逮捕和监禁的比例不成比例以及相关危害的社会结构因素。
