Great Expectations: HIV Risk Behaviors and Misperceptions of Low HIV Risk among Incarcerated Men
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Incarcerated populations have relatively high HIV prevalence but little has been reported about their aggregate HIV risk behaviors or perceptions of risk. A random selection of HIV-negative men (n = 855) entering a US state prison system were surveyed to assess five risk behaviors and his self-perceived HIV risk. Using multivariate logistic regression, we identified factors associated with having elevated actual but low perceived risk (EALPR). Of the 826 men with complete data, 88% were at elevated risk. While 64% of the sample had risk perceptions concordant with their actual risk, 14% had EALPR (with the remainder at low actual but high perceived risk). EALPR rates were lower in those with a pre-incarceration HIV test but higher for those with a negative prison entry HIV test. HIV testing counseling should assess for discordance between actual and perceived risk and communicate the continued risk of HIV despite a negative result.
KeywordsHIV Risk behavior Risk perceptions Incarcerated populations
This study was supported by the National Institute of Mental Health (R01 MH079720-01A1). Dr. Golin’s salary for conducting this work was partly supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (K24-HD06920 K24-DA037101). Mr. Barkley was partially supported by a T32 training Grant (T32ES007018). Additional support was provided by the University of North Carolina at Chapel Hill Center for AIDS Research (CFAR) (P30 AI-50410). We would like to acknowledge Dr. Michael Hudgens assistance with statistical analytic planning, Dr. Angela Thrasher for editorial assistance, Ms. Jennifer Lawall for data cleaning, Ms. Kelly Green for her assistance with study data collection and management and Monique Williams, Dani Strauss, Makisha Ruffin, and Catherine Grodensky for assistance with data collection. The authors thank the NCDPS, as well as the participants in the study.
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Conflict of interest
The authors have no disclosures to report.
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