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

摘要

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 everbeen incarcerated (aOR = 3.20; 95% CI 1.07–9.63)was independently associated with a history of trans-actional sex. Being 24 years vs. younger (aOR =9.68; 95% CI 1.42–65.78) and having ever beenhomeless (aOR = 3.71, 95% CI 1.18–11.65) alsoremained independently associated with a history oftransactional sex. This analysis fills a gap in theliterature by examining the relationship between in-carceration and transactional sex among HIV-infected YMSM. Facilitating youths’ engagement with social services available in their HIV clinic mayserve as a key strategy in promoting health. Publichealth efforts need to address social-structural factorsdriving disproportionate rates of arrest and incarcer-ation and related harms among this population.