Self-Reported Sexually Transmitted Infections After Incarceration in Women with or at Risk for HIV in the United States, 2007-2017

J Womens Health (Larchmt). 2022 Mar;31(3):382-390. doi: 10.1089/jwh.2021.0215. Epub 2021 Dec 30.


Background: U.S. women who have been incarcerated report high rates of sexual risk behavior and sexually transmitted infections (STIs). Materials and Methods: We estimated the effect of incarceration on the time to first incident STI in a multicenter cohort of U.S. women with or at risk for HIV. We used marginal structural models to compare time to first self-reported gonorrhea, chlamydia, or trichomonas infection for nonincarcerated women and incarcerated women. Covariates included demographic factors, HIV status, sex exchange, drug/alcohol use, and prior incarceration. Results: Three thousand hundred twenty-four women contributed a median of 4 at-risk years and experienced 213 first incident STI events. The crude incidence of STIs was 3.7 per 100 person-years for incarcerated women and 1.9 per 100 person-years for nonincarcerated women. The weighted hazard ratio for incident STIs was 4.05 (95% confidence interval: 1.61-10.19). Conclusion: Women with or at risk for HIV in the United States who have recently experienced incarceration may be at increased STI risk.

Keywords: STI; chlamydia; gonorrhea; incarceration; trichomonas; women.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Chlamydia Infections* / epidemiology
  • Female
  • Gonorrhea* / epidemiology
  • HIV Infections* / epidemiology
  • Humans
  • Self Report
  • Sexual Behavior
  • Sexually Transmitted Diseases* / epidemiology
  • Trichomonas Infections* / epidemiology
  • United States / epidemiology