Department of Medicine, Chicago Center for HIV Elimination, University of Chicago, 5837 S. Maryland Ave, L-038, Chicago, IL, 60637, USA.
Department of Public Health Sciences, University of Chicago, Chicago, IL, USA.
J Urban Health. 2020 Oct;97(5):623-634. doi: 10.1007/s11524-020-00428-8.
Black men who have sex with men (MSM) and transgender women are disproportionately affected by criminal justice involvement (CJI) and HIV. This study recruited 618 young Black MSM and transgender women in Chicago, IL, using respondent-driven sampling between 2013 and 2014. Random effects logistic regression evaluated predictors of incident CJI over 18 months of follow-up. Controlling for respondent age, gender and sexual identity, spirituality (aOR 0.56, 95% CI 0.33-0.96), and presence of a mother figure (aOR 0.41, 95% CI 0.19-0.89) were protective against CJI. Economic hardship (financial or residential instability vs. neither aOR 2.23, 95% CI 1.10-4.51), two or more past episodes of CJI vs. none (aOR 2.66, 95% CI 1.40-5.66), and substance use (marijuana use vs. none aOR 2.79, 95% CI 1.23-6.34; other drug use vs. none aOR 4.49, 95% CI 1.66-12.16) were associated with CJI during follow-up. Research to identify and leverage resilience factors that can buffer the effects of socioeconomic marginalization may increase the effectiveness of interventions to address the socio-structural factors that increase the risk for CJI among Black MSM and transgender women. Given the intersection of incarceration, HIV and other STIs, and socio-structural stressors, criminal justice settings are important venues for interventions to reduce health inequities in these populations.
男男性行为者和跨性别女性的黑人受刑事司法涉入(CJI)和艾滋病毒的影响不成比例。本研究于 2013 年至 2014 年期间在伊利诺伊州芝加哥使用应答者驱动抽样方法招募了 618 名年轻的黑人男男性行为者和跨性别女性。随机效应逻辑回归评估了在 18 个月的随访期间新发生 CJI 的预测因素。在控制应答者年龄、性别和性身份的情况下,精神信仰(优势比 0.56,95%置信区间 0.33-0.96)和存在母亲形象(优势比 0.41,95%置信区间 0.19-0.89)是 CJI 的保护因素。经济困难(经济或居住不稳定与两者均无 aOR 2.23,95%置信区间 1.10-4.51)、过去有两次或两次以上 CJI 发作与无发作 aOR 2.66,95%置信区间 1.40-5.66)和物质使用(大麻使用与无使用 aOR 2.79,95%置信区间 1.23-6.34;其他药物使用与无使用 aOR 4.49,95%置信区间 1.66-12.16)与随访期间的 CJI 相关。研究识别和利用可以缓冲社会经济边缘化影响的恢复力因素,可能会提高干预措施的有效性,以解决增加黑人男男性行为者和跨性别女性 CJI 风险的社会结构因素。鉴于监禁、艾滋病毒和其他性传播感染以及社会结构压力源之间的交集,刑事司法环境是减少这些人群健康不平等的重要干预场所。