STI/HIV Sexual Risk Behavior and Prevalent STI Among Incarcerated African American Men in Committed Partnerships: The Significance of Poverty, Mood Disorders, and Substance Use

AIDS Behav. 2015 Aug;19(8):1478-90. doi: 10.1007/s10461-015-1062-6.


African Americans face disproportionate sexually transmitted infection including HIV (STI/HIV), with those passing through a correctional facility at heightened risk. There is a need to identify modifiable STI/HIV risk factors among incarcerated African Americans. Project DISRUPT is a cohort study of incarcerated African American men recruited from September 2011 through January 2014 from prisons in North Carolina who were in committed partnerships with women at prison entry (N = 207). During the baseline (in-prison) study visit, participants responded to a risk behavior survey and provided a urine specimen, which was tested for STIs. Substantial proportions reported multiple partnerships (42 %), concurrent partnerships (33 %), and buying sex (11 %) in the 6 months before incarceration, and 9 % tested positive for an STI at baseline (chlamydia: 5.3 %, gonorrhea: 0.5 %, trichomoniasis: 4.9 %). Poverty and depression appeared to be strongly associated with sexual risk behaviors. Substance use was linked to prevalent STI, with binge drinking the strongest independent risk factor (adjusted odds ratio: 3.79, 95 % CI 1.19-12.04). There is a continued need for improved prison-based STI testing, treatment, and prevention education as well as mental health and substance use diagnosis.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Black or African American / psychology*
  • Cross-Sectional Studies
  • HIV Infections / epidemiology*
  • HIV Infections / psychology
  • Humans
  • Male
  • Middle Aged
  • Mood Disorders / psychology*
  • North Carolina / epidemiology
  • Poverty*
  • Prevalence
  • Prisoners* / statistics & numerical data
  • Prisons
  • Risk Factors
  • Risk-Taking
  • Sexual Behavior / statistics & numerical data
  • Sexual Partners
  • Sexually Transmitted Diseases / epidemiology*
  • Sexually Transmitted Diseases / psychology
  • Substance-Related Disorders / psychology*
  • Unsafe Sex / statistics & numerical data