Journal of Urban Health

, Volume 95, Issue 4, pp 576–583 | Cite as

The Association between Incarceration and Transactional Sex among HIV-infected Young Men Who Have Sex with Men in the United States

  • Morgan M. Philbin
  • Elizabeth N. Kinnard
  • Amanda E. Tanner
  • Samuella Ware
  • Brittany D. Chambers
  • Alice Ma
  • J. Dennis Fortenberry


Criminal justice practices in the USA disproportionately affect sexual and racial/ethnic minority men, who are at higher risk of incarceration. Previous research demonstrates associations between incarceration and sexual risk behaviors for men who have sex with men (MSM). However, little of this work focuses on young MSM (YMSM), particularly HIV-infected YMSM, despite nearly one-third reporting engagement in sexual risk behaviors, such as transactional sex. We therefore explored the association between incarceration and transactional sex among HIV-infected YMSM. We recruited 97 HIV-infected YMSM across 14 clinical sites in urban centers from August 2015 to February 2016. We used multivariate logistic regression to examine the relationship between incarceration and transactional sex among YMSM. The majority was 24 years old (78%) and racial/ethnic minority (95%); over half were not in school and reported an annual income of < $12,000. In the multivariate model, having ever been incarcerated (aOR = 3.20; 95% CI 1.07–9.63) was independently associated with a history of transactional sex. Being 24 years vs. younger (aOR = 9.68; 95% CI 1.42–65.78) and having ever been homeless (aOR = 3.71, 95% CI 1.18–11.65) also remained independently associated with a history of transactional sex. This analysis fills a gap in the literature by examining the relationship between incarceration and transactional sex among HIV-infected YMSM. Facilitating youths’ engagement with social services available in their HIV clinic may serve as a key strategy in promoting health. Public health efforts need to address social-structural factors driving disproportionate rates of arrest and incarceration and related harms among this population.


Incarceration Transactional sex Young men who have sex with men (YMSM) HIV Health disparities 



This work was supported by The Adolescent Trials Network for HIV/AIDS Interventions (ATN) (A.E. Tanner, Protocol Chair) from the National Institutes of Health [U01 HD 040533 and U01 HD 040474] through the National Institute of Child Health and Human Development (B. Kapogiannis), with supplemental funding from the National Institutes on Drug Abuse (S. Kahana) and Mental Health (P. Brouwers, S. Allison). Morgan Philbin was supported by a NIDA-funded K01 (K01DA039804A).


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Copyright information

© The New York Academy of Medicine 2018

Authors and Affiliations

  • Morgan M. Philbin
    • 1
  • Elizabeth N. Kinnard
    • 1
  • Amanda E. Tanner
    • 2
  • Samuella Ware
    • 2
  • Brittany D. Chambers
    • 3
  • Alice Ma
    • 4
  • J. Dennis Fortenberry
    • 5
  1. 1.Department of Sociomedical SciencesColumbia University Mailman School of Public HealthNew YorkUSA
  2. 2.Department of Public Health EducationUniversity of North Carolina GreensboroGreensboroUSA
  3. 3.Preterm Birth InitiativeUniversity of California San FranciscoSan FranciscoUSA
  4. 4.Department of Applied HealthSouthern Illinois University EdwardsvilleEdwardsvilleUSA
  5. 5.Department of PediatricsIndiana University School of MedicineIndianapolisUSA

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