School of Public Health, Brown University, Providence, Rhode Island, USA.
Department of Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.
AIDS Patient Care STDS. 2022 Aug;36(8):291-299. doi: 10.1089/apc.2022.0083.
More than 2 million people are incarcerated in the United States with many millions more processed through correctional facilities annually. Communities impacted by incarceration are also disproportionately impacted by the HIV and sexually transmitted infection (STI) epidemics. However, relatively little is known about the behaviors that place individuals with a history of incarceration at risk for HIV/STI acquisition. We utilized clinical data from patients presenting to an STI clinic located in Providence, Rhode Island. A latent class analysis was conducted on reported HIV acquisition risk behavior and STI testing results on a total of 1129 encounters where a history of incarceration was reported. A total of three classes were identified. Class 1 ( = 187, 11%), more frequently reported 10+ sexual partners (45%), an STI diagnosis (48%) and sex while intoxicated (86%) in the past year as well as identifying as a man who has sex with other men (60%). Class 2 ( = 57, 5%) was more likely to report giving (53%) and receiving (44%) money/drugs for sex in the past year as well as a history of injecting drugs (61%) and using methamphetamine (60%). Class 3 ( = 885, 78%) most frequently reported 0-2 sexual partners (48%), identified as Black (27%), Hispanic/Latino (69%) and a man who only has sex with women (80%). Class 1 had significantly higher odds ratio (1.8, 95% confidence interval = 1.3-2.5) of testing HIV/STI positive. The results provide important insights into risk subgroups for those with a history of incarceration at risk of HIV/STI acquisition.
超过 200 万人被关押在美国,每年还有数以百万计的人在监狱服刑。受监禁影响的社区也不成比例地受到艾滋病毒和性传播感染(STI)疫情的影响。然而,对于那些有监禁史的人,哪些行为会使他们面临艾滋病毒/性传播感染的风险,人们知之甚少。我们利用了位于罗得岛普罗维登斯市的一家性传播感染诊所的临床数据。对总共 1129 次就诊的报告的艾滋病毒感染风险行为和性传播感染检测结果进行了潜在类别分析,这些就诊都报告了有监禁史。共确定了三个类别。第 1 类( = 187,11%),过去一年中更频繁地报告了 10 多个性伴侣(45%)、性传播感染诊断(48%)和醉酒性行为(86%),并自认为是男男性行为者(60%)。第 2 类( = 57,5%)更有可能报告过去一年中为性支付(53%)和接受(44%)金钱/毒品,以及有注射毒品史(61%)和使用冰毒(60%)。第 3 类( = 885,78%)最常报告 0-2 个性伴侣(48%),自认为是黑人(27%)、西班牙裔/拉丁裔(69%)和只与女性发生性关系的男性(80%)。第 1 类检测出艾滋病毒/性传播感染阳性的比值比(OR)显著更高(1.8,95%置信区间 = 1.3-2.5)。研究结果为那些有监禁史、面临艾滋病毒/性传播感染风险的人群提供了重要的风险亚组信息。