Gender and risk behaviors for HIV and sexually transmitted infections among recently released inmates: A prospective cohort study
Gender and risk behaviors for HIV and sexually transmitted infections among recently released inmates: A prospective cohort study
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DOI：
10.1080/09540121.2013.859650
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发表时间：
2014-07-03
影响因子：
1.7
通讯作者：
Corsi, Karen F.
中科院分区：
文献类型：
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作者：
Binswanger, Ingrid A.;Mueller, Shane R.;Corsi, Karen F.
监狱中的女性艾滋病毒感染率高于男性。出狱后，前囚犯有机会从事艾滋病毒和其他性传播感染 (STI) 的危险行为。我们试图评估风险行为随时间的变化以及性别与释放后风险行为的关联。在这项前瞻性队列研究中，我们在出狱后大约两周（基线）和三个月（随访）采访了 200 名前囚犯（51 名女性），并在随访时对他们进行了 HIV 感染检测。我们使用卡方和费舍尔精确检验以及多变量逻辑回归检查了过去 7 天内性别与无保护阴道性交或肛交的关联。基线时，22% 的男性和 41% 的女性报告了无保护的阴道性交 (p < 0.01)，5% 的男性和 8% 的女性报告了无保护的肛交 (p = 0.51)。年龄较小（OR 每十年增加 0.48，95% CI = 0.29-0.80），是男同性恋/女同性恋或双性恋（与异性恋相比，OR = 4.74，95% CI = 1.01-22.17 和 OR = 3.98，95% CI = 1.41-11.26），或报告选择的药物在调整种族、无家可归和危险饮酒后，海洛因/速球或可卡因/快克（与大麻/无选择药物相比，OR = 24.00，95% CI = 5.15-111.81 和 OR = 3.49，95% CI = 1.20-10.18）与无保护的阴道性交或肛交相关。随访时，21% 的男性和 44% 的女性报告无保护性行为（p = 0.005），女性（OR = 4.42，95% CI = 1.79-10.94）和危险饮酒（与不符合危险饮酒标准相比，OR = 3.64，95% CI = 1.34-9.86）与无保护性行为相关，根据种族和性别进行调整。无家可归。在这个艾滋病毒高发人群中，我们在释放后期间表现出持续的危险性行为。需要加强努力，促进性健康并减少男女现任和前任监狱囚犯的危险行为，包括改善获得预防性护理以及艾滋病毒和性传播感染筛查、检测和治疗的机会。
Women in prison have a higher prevalence of HIV than men. After release from prison, former inmates have the opportunity to engage in risk behaviors for HIV and other sexually transmitted infections (STIs). We sought to assess change in risk behaviors over time and the association of gender with risk behavior in the postrelease period. In this prospective cohort study, we interviewed 200 former inmates (51 women) approximately two weeks (baseline) and three months (follow-up) after release and tested them for HIV infection at follow-up. We examined the association of gender with unprotected vaginal or anal sex in the last seven days using chi-square and Fisher's exact tests and multivariable logistic regression. At baseline, 22% of men and 41% of women reported unprotected vaginal sex (p < 0.01) and 5% of men and 8% of women reported unprotected anal sex (p = 0.51). Being younger (OR for each decade increase 0.48, 95% CI = 0.29-0.80), being gay/lesbian or being bisexual (compared with being heterosexual, OR = 4.74, 95% CI = 1.01-22.17 and OR = 3.98, 95% CI = 1.41-11.26, respectively), or reporting a drug of choice of heroin/speedballs or cocaine/crack (compared with marijuana/no drug of choice, OR = 24.00, 95% CI = 5.15-111.81 and OR = 3.49, 95% CI = 1.20-10.18, respectively) was associated with unprotected vaginal or anal sex after adjusting for race, homelessness, and hazardous drinking. At follow-up, 21% of men and 44% of women reported unprotected sex (p = 0.005), and female gender (OR = 4.42, 95% CI = 1.79-10.94) and hazardous drinking (compared with not meeting criteria for hazardous drinking, OR = 3.64, 95% CI = 1.34-9.86) were associated with unprotected sex, adjusting for race and homelessness. In this population with a high prevalence of HIV, we demonstrated persistent engagement in sexual risk behavior during the postrelease period. Enhanced efforts to promote sexual health and reduced risk behavior among both male and female current and former prison inmates are needed, including improved access to preventive care and HIV and STI screening, testing, and treatment.