Black individuals in the USA are arrested and incarcerated at a significantly higher rate than White individuals, and incarceration is associated with increased HIV vulnerability. Pre-exposure prophylaxis (PrEP) reduces the risk for HIV transmission, but little is known about the relationship between HIV risk behavior and willingness to use PrEP among Black individuals with an arrest history.
A total of 868 individuals completed a nationally representative survey and provided baseline data on sexual risk. Participants were grouped as those with a history of arrest (N = 226) and those with no history of arrest (N=619) based on self-reported arrest history. Our study examined HIV risk behaviors associated with willingness to use PrEP between those with arrest history and those without arrest history.
Participants with an arrest history were more likely to have a lifetime history of anal sex (p<0.0001) and sexually transmitted diseases (p=0.0007). A history of multiple sexual partners in the past 3 months was associated with PrEP willingness in individuals with an arrest history [aPR 2.61 (1.77, 3.85), p<0.0001], adjusting for other covariates in the model.
Differences in risk behavior and willingness to use PrEP exist by arrest history. Understanding these risk behaviors are necessary to increase access to PrEP. PrEP uptake and adherence interventions, when recommended and made available for individuals at substantive risk of HIV infection at the time of arrest and during incarceration, are essential to reducing the spread of HIV in correctional facilities and in communities to which they return.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Tax calculation will be finalised during checkout.
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
Tax calculation will be finalised during checkout.
“HIV by Group | HIV/AIDS | CDC.” 2019. https://www.cdc.gov/hiv/group/index.html (accessed May 21, 2020).
Canterbury RJ, McGarvey EL, Sheldon-Keller AE, Waite D, Reams P, Koopman C. Prevalence of HIV-related risk behaviors and STDs among incarcerated adolescents. J Adolesc Health. 1995;17(3):173–7. https://doi.org/10.1016/1054-139X(95)00043-R.
van der Meulen E. ‘It goes on everywhere’: injection drug use in Canadian Federal Prisons. Subst Use Misuse. 2017;52(7):884–91. https://doi.org/10.1080/10826084.2016.1264974.
Stone J, Fraser H, Lim AG, Walker JG, Ward Z, MacGregor L, et al. Incarceration history and risk of HIV and hepatitis C virus acquisition among people who inject drugs: a systematic review and meta-analysis. Lancet Infect Dis. 2018;18(12):1397–409. https://doi.org/10.1016/S1473-3099(18)30469-9.
Jürgens R, Nowak M, Day M. HIV and incarceration: prisons and detention. J Int AIDS Soc. 2011;14:26. https://doi.org/10.1186/1758-2652-14-26.
Khan MR, McGinnis KA, Grov C, Scheidell JD, Hawks L, Edelman EJ, et al. Past year and prior incarceration and HIV transmission risk among HIV-positive men who have sex with men in the US. AIDS Care. 2019;31(3):349–56. https://doi.org/10.1080/09540121.2018.1499861.
Bourey C, Stephenson R, Bautista-Arredondo S. Syndemic vulnerability and condomless sex among incarcerated men in Mexico City: a latent class analysis. AIDS Behav. 2018;22(12):4019–33. https://doi.org/10.1007/s10461-018-2216-0.
Teplin LA, Elkington KS, McClelland GM, Abram KM, Mericle AA, Washburn JJ. Major mental disorders, substance use disorders, comorbidity, and HIV-AIDS risk behaviors in juvenile detainees. Psychiatr Serv. 2005;56(7):823–8. https://doi.org/10.1176/appi.ps.56.7.823.
Kingree JB, Betz H. Risky sexual behavior in relation to marijuana and alcohol use among African–American, male adolescent detainees and their female partners. Drug and Alcohol Depend. 2003;72(2):197–203. https://doi.org/10.1016/S0376-8716(03)00196-0.
Kramer K, Comfort M. Considerations in HIV prevention for women affected by the criminal justice system. Women’s Health Issues. 2011;21(6):S272–7. https://doi.org/10.1016/j.whi.2011.05.009.
Binswanger IA, Redmond N, Steiner JF, Hicks LS. Health disparities and the criminal justice system: an agenda for further research and action. J Urban Health. 2012;89(1):98–107. https://doi.org/10.1007/s11524-011-9614-1.
Beckwith C, Bazerman L, Gillani F, Tran L, Larson B, Rivard S, et al. The feasibility of implementing the HIV seek, test, and treat strategy in jails. AIDS Patient Care STDS. 2014;28(4):183–7. https://doi.org/10.1089/apc.2013.0357.
Rich JD, Chandler R, Williams BA, Dumont D, Wang EA, Taxman FS, et al. How health care reform can transform the health of criminal justice–involved individuals. Health Aff (Millwood). 2014;33(3):462–7. https://doi.org/10.1377/hlthaff.2013.1133.
Rich JD, et al. Correctional facilities as partners in reducing HIV disparities. J Acquir Immune Defic Syndr. 2013;63(0 1):S49–53. https://doi.org/10.1097/QAI.0b013e318292fe4c.
Koehn JD, Bach P, Hayashi K, Nguyen P, Kerr T, Milloy MJ, et al. Impact of incarceration on rates of methadone use in a community recruited cohort of injection drug users. Addict Behav. 2015;46:1–4. https://doi.org/10.1016/j.addbeh.2015.01.038.
Binswanger IA, et al. Release from prison — a high risk of death for former inmates. 10.1056/NEJMsa064115. 2009. https://www.nejm.org/doi/10.1056/NEJMsa064115?url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub++0www.ncbi.nlm.nih.gov (accessed May 21, 2020).
“cdc-hiv-prep-guidelines-2017.pdf.” Accessed: Sep. 26, 2019. [Online]. Available: https://www.cdc.gov/hiv/pdf/risk/prep/cdc-hiv-prep-guidelines-2017.pdf.
Brinkley-Rubinstein L, Dauria E, Tolou-Shams M, Christopoulos K, Chan PA, Beckwith CG, et al. The path to implementation of HIV pre-exposure prophylaxis for people involved in criminal justice systems. Curr HIV/AIDS Rep. 2018;15(2):93–5. https://doi.org/10.1007/s11904-018-0389-9.
Underhill K, Dumont D, Operario D. HIV prevention for adults with criminal justice involvement: a systematic review of HIV risk-reduction interventions in incarceration and community settings. Am J Public Health. Nov. 2014;104(11):e27–53. https://doi.org/10.2105/AJPH.2014.302152.
Krakower DS, et al. Limited awareness and low immediate uptake of pre-exposure prophylaxis among men who have sex with men using an internet social networking site. PLoS One. 2012;7:3. https://doi.org/10.1371/journal.pone.0033119.
Rucinski KB, Mensah NP, Sepkowitz KA, Cutler BH, Sweeney MM, Myers JE. Knowledge and use of pre-exposure prophylaxis among an online sample of young men who have sex with men in New York City. AIDS Behav. 2013;17(6):2180–4. https://doi.org/10.1007/s10461-013-0443-y.
“Persons Arrested,” FBI. https://ucr.fbi.gov/crime-in-the-u.s/2017/crime-in-the-u.s.-2017/topic-pages/persons-arrested (accessed Nov. 29, 2020).
Branson B. Current HIV epidemiology and revised recommendations for HIV testing in health-care settings. J Med Virol. 2007;79(S1):S6–S10. https://doi.org/10.1002/jmv.20972.
“Routine HIV screening during intake medical evaluation at a county jail — Fulton County, Georgia, 2011–2012.” https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6224a3.htm (accessed Nov. 29, 2020).
“Routine jail-based HIV testing --- Rhode Island, 2000--2007.” https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5924a3.htm?s_cid=mm5924a3_w (accessed Nov. 29, 2020).
Ojikutu BO, Srinivasan S, Bogart LM, Subramanian SV, Mayer KH. Mass incarceration and the impact of prison release on HIV diagnoses in the US South. PLoS One. 2018;13(6). https://doi.org/10.1371/journal.pone.0198258.
Ojikutu BO, Amutah-Onukagha N, Mahoney TF, Tibbitt C, Dale SD, Mayer KH, et al. HIV-related mistrust (or HIV conspiracy theories) and willingness to use PrEP among Black women in the United States. AIDS Behav. 2020;24(10):2927–34. https://doi.org/10.1007/s10461-020-02843-z.
Ojikutu BO, Bogart LM, Higgins-Biddle M, Dale SK, Allen W, Dominique T, et al. Facilitators and barriers to pre-exposure prophylaxis (PrEP) use among Black individuals in the United States: results from the National Survey on HIV in the Black Community (NSHBC). AIDS Behav. 2018;22(11):3576–87. https://doi.org/10.1007/s10461-018-2067-8.
Belenko S, Langley S, Crimmins S, Chaple M. HIV risk behaviors, knowledge, and prevention education among offenders under community supervision: a hidden risk group. AIDS Educ Prev. 2004;16(4):367–85. https://doi.org/10.1521/aeap.16.4.367.40394.
O’Brien CP, Charney DS, Lewis L, Cornish JW, Post RM, Woody GE, et al. Priority actions to improve the care of persons with co-occurring substance abuse and other mental disorders: a call to action. Biol Psychiatry. 2004;56(10):703–13. https://doi.org/10.1016/j.biopsych.2004.10.002.
Freudenberg N, Daniels J, Crum M, Perkins T, Richie BE. Coming home from jail: the social and health consequences of community reentry for women, male adolescents, and their families and communities. Am J Public Health. 2005;95(10):1725–36. https://doi.org/10.2105/AJPH.2004.056325.
Cotten-Oldenburg NU, Jordan BK, Martin SL, Kupper L. Women inmates’ risky sex and drug behaviors: are they related? Am J Drug Alcohol Abuse. 1999;25(1):129–49. https://doi.org/10.1081/ADA-100101850.
Rutledge R, Madden L, Ogbuagu O, Meyer JP. HIV risk perception and eligibility for pre-exposure prophylaxis in women involved in the criminal justice system. AIDS Care. 2018;30(10):1282–9. https://doi.org/10.1080/09540121.2018.1447079.
“Importance of PrEP for people involved in criminal justice systems,” Infectious Disease Advisor, May 18, 2018. https://www.infectiousdiseaseadvisor.com/home/topics/hiv-aids/importance-of-prep-for-people-involved-in-criminal-justice-systems/ (accessed Oct. 06, 2020).
We want to thank the National Advisory Committee who created the survey. This publication was made possible with help from the Harvard University Center for AIDS Research (CFAR), an NIH funded program (P30 AI060354).
Data, Materials, and/or Code Availability
All data and materials as well as SAS version 9.4 support our findings and comply with field standards.
This study was supported by grants from Harvard University Center for AIDS Research (HU CFAR NIH/NAIDS P30-AI 060354). Dr. Bogart was also supported by P30MH058107.
Ethical approval was obtained from the Boston Children’s Hospital Institutional Review Board.
Informed consent was obtained from all individual participants included in the study.
Conflict of Interest
The authors declare no conflicts of interest.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
About this article
Cite this article
Uzoeghelu, U., Bogart, L.M., Mahoney, T. et al. HIV Risk-Related Behaviors and Willingness to Use Pre-Exposure Prophylaxis Among Black Americans with an Arrest History. J. Racial and Ethnic Health Disparities (2021). https://doi.org/10.1007/s40615-021-00980-2
- HIV risk
- Arrest history
- Correctional facilities