Division of Comparative Effectiveness and Decision Science, Department of Population Health, New York University Grossman School of Medicine, New York, New York, USA.
Division of Epidemiology, Department of Population Health, New York University Grossman School of Medicine, New York, New York, USA.
J Womens Health (Larchmt). 2022 Feb;31(2):242-251. doi: 10.1089/jwh.2020.8980. Epub 2021 May 28.
Incarceration is linked to risk of sexually transmitted infection (STI) postrelease among women. There has been little examination of incarceration's association with related sexual and reproductive outcomes such as pelvic inflammatory disease (PID) and pregnancy loss, or the role of STI in this relationship and whether these relationships differ between Black and White women. Using data from the National Longitudinal Study of Adolescent to Adult Health, we examined cross-sectional associations between incarceration (Wave IV; 2007-2008; ages 24-34) and history of STI and PID ( = 5,968), and longitudinal associations between incarceration and later pregnancy loss in mid-adulthood (Wave V; 2016-2018; ages 34-43) among women who had ever been pregnant ( = 2,353); we estimated racial differences. Using causal mediation, we explored whether STI mediated associations with pregnancy loss. Incarceration was associated with a history of STI (White adjusted prevalence ratio [APR]: 1.54, 95% confidence interval [CI] 1.14-2.06; Black APR: 1.26, 95% CI 1.02-1.56); the association between incarceration and PID was null among White women (APR: 0.99, 95% CI 0.47-2.09) and elevated among Black women (APR: 2.82, 95% CI 1.36-5.83). Prior incarceration did not appear associated with pregnancy loss among White women (APR: 1.01, 95% CI 0.70-1.45), but was associated among Black women (APR: 1.38, 95% CI: 0.97-1.97), with STI appearing to partially mediate. Pregnancy loss may be elevated among Black women who have been incarcerated, and incarceration-related increases in STI may account for some of this association.
监禁与女性出狱后性传播感染（STI）的风险有关。人们很少检查监禁与相关的性和生殖结果（如盆腔炎（PID）和妊娠丢失）之间的关联，也很少检查 STI 在这种关系中的作用，以及这些关系在黑人和白人女性之间是否存在差异。使用来自全国青少年至成人健康纵向研究的数据，我们检查了监禁（第四波；2007-2008 年；年龄 24-34 岁）与 STI 和 PID 病史之间的横断面关联（n=5968），以及监禁与中年以后妊娠丢失之间的纵向关联（第五波；2016-2018 年；年龄 34-43 岁），其中曾怀孕的女性（n=2353）；我们估计了种族差异。通过因果中介，我们探讨了 STI 是否介导了与妊娠丢失的关联。监禁与 STI 病史相关（白人调整后的比值比 [APR]：1.54，95%置信区间 [CI]：1.14-2.06；黑人 APR：1.26，95% CI：1.02-1.56）；监禁与 PID 之间的关联在白人女性中为零（APR：0.99，95% CI：0.47-2.09），在黑人女性中升高（APR：2.82，95% CI：1.36-5.83）。在白人女性中，先前的监禁似乎与妊娠丢失无关（APR：1.01，95% CI：0.70-1.45），但在黑人女性中与妊娠丢失相关（APR：1.38，95% CI：0.97-1.97），STI 似乎部分介导了这种关联。监禁可能会使黑人女性的妊娠丢失率升高，而监禁相关的 STI 增加可能是造成这种关联的部分原因。
