African American men released from prison face disproportionate HIV risk. Preventing HIV sexual risk behavior and drug use in this group is critical to reducing the race disparity in HIV. However, research on the factors that drive and protect against HIV risk among African American male releasees is limited. Returning to a committed partner after release may be an important protective factor against HIV risk among African American male releasees during reentry. However, incarceration destabilizes committed relationships. Though 50-80% of men enter prison in a committed relationship, we estimate that half of these relationships end by the time of release. Upon release, loss of a partner may lead men to seek multiple, new partners to meet companionship needs or may lead to distress and, in turn, self-medication with drugs or sex. No prior study has evaluated the degree to which partner loss during incarceration influences post-release HIV risk. The present mixed method study is designed to address this gap in the current field of HIV prevention science. This study seeks to examine the hypothesis that dissolution of stable intimate relationships during incarceration elevates sexual risk behavior and drug use among inmates upon their release.
The specific aims are: Primary Quantitative Aims:
Aim 1. Among African American men in relationships at the time of prison entry, to describe the associations between dissolution of relationships during incarceration and HIV sexual risk behavior (unprotected sex;multiple sex partnerships;buying sex for money or drugs) and drug use (crack use;binge drinking).
Aim 2. To assess whether diminished mental health (low coping;increased depression;increased anxiety) due to dissolution of relationships during incarceration results in HIV sexual risk behavior and drug use.
Aim 3. To evaluate whether the association between dissolution of relationships during incarceration and HIV sexual risk behavior and drug use varies by respondent and relationship characteristics. Qualitative Aim: To qualitatively explore the social context of post-release and men's perceptions of the factors and processes driving post-release sexual risk behavior and drug use. To accomplish these study aims, we propose to recruit 400 African American male inmates who are scheduled to be released from prison and who were in stable intimate heterosexual relationships at the time of prison entry. Our pilot work suggests that ~50% of relationships will have ended during the incarceration. We will follow men after their release to assess whether post-release sexual risk behavior and drug use are higher among men whose relationships ended during incarceration versus men whose relationships remained intact. The proposed study is designed to inform development of policies and interventions that minimize the destabilizing effects of criminal justice involvement on relationships and health.

Public Health Relevance

Since more than 800,000 African American men are incarcerated in prison at any given time, and hundreds of thousands return home to their communities each year, policies and programs that are effective in reducing HIV risk in this group would prevent substantial numbers of new infections among African American men and members of their sexual networks annually. This research will determine whether dissolution of committed relationships during incarceration is a risk factor for post-release HIV sexual risk behavior and drug use among African American male releasees and will describe the pathways through which relationship dissolution may work to influence HIV risk. Study findings may highlight the need for implementation of criminal justice policies that reduce network disruption and may inform HIV prevention interventions, including in-prison programs for inmates and their partners that foster communication and prevent relationship dissolution, and pre-release HIV prevention education for men who have lost a committed partner during incarceration.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Research Project (R01)
Project #
5R01DA028766-02
Application #
8114996
Study Section
Special Emphasis Panel (ZRG1-AARR-F (03))
Program Officer
Deeds, Bethany
Project Start
2010-08-01
Project End
2012-04-30
Budget Start
2011-08-01
Budget End
2012-04-30
Support Year
2
Fiscal Year
2011
Total Cost
$554,840
Indirect Cost
Name
University of Maryland College Park
Department
Biostatistics & Other Math Sci
Type
Schools of Public Health
DUNS #
790934285
City
College Park
State
MD
Country
United States
Zip Code
20742
Dyer, Typhanye V; Khan, Maria R; Regan, Rotrease et al. (2018) Differential Patterns of Risk and Vulnerability Suggest the Need for Novel Prevention Strategies for Black Bisexual Men in the HPTN 061 Study. J Acquir Immune Defic Syndr 78:491-498
Scheidell, Joy D; Lejuez, Carl W; Golin, Carol E et al. (2017) Patterns of Mood and Personality Factors and Associations With STI/HIV-Related Drug and Sex Risk Among African American Male Inmates. Subst Use Misuse 52:929-938
Scheidell, Joy D; Friedman, Samuel R; Golin, Carol et al. (2017) Group sex event participation: a link to STI risk among African-American heterosexual men incarcerated in North Carolina. Sex Transm Infect 93:144
Coatsworth, Ashley M; Scheidell, Joy D; Wohl, David A et al. (2017) HIV-Related Sexual Risk among African American Men Preceding Incarceration: Associations with Support from Significant Others, Family, and Friends. J Urban Health 94:136-148
Dyer, Typhanye V; Khan, Maria R; Sandoval, Milagros et al. (2017) Drug Use and Sexual HIV Transmission Risk Among Men Who have Sex with Men and Women (MSMW), Men Who have Sex with Men only (MSMO), and Men Who have Sex with Women Only (MSWO) and the Female Partners of MSMW and MSWO: A Network Perspective. AIDS Behav 21:3590-3598
Khan, Maria R; El-Bassel, Nabila; Golin, Carol E et al. (2017) The Committed Intimate Partnerships of Incarcerated African-American Men: Implications for Sexual HIV Transmission Risk and Prevention Opportunities. Arch Sex Behav 46:2173-2185
Scheidell, Joy D; Lejuez, Carl W; Golin, Carol E et al. (2016) Borderline Personality Disorder Symptom Severity and Sexually Transmitted Infection and HIV Risk in African American Incarcerated Men. Sex Transm Dis 43:317-23
Dyer, Typhanye P; Regan, Rotrease; Pacek, Lauren R et al. (2015) Psychosocial vulnerability and HIV-related sexual risk among men who have sex with men and women in the United States. Arch Sex Behav 44:429-41
Khan, M R; Golin, C E; Friedman, S R et al. (2015) STI/HIV Sexual Risk Behavior and Prevalent STI Among Incarcerated African American Men in Committed Partnerships: The Significance of Poverty, Mood Disorders, and Substance Use. AIDS Behav 19:1478-90
Regan, Rotrease; Dyer, Typhanye Penniman; Gooding, Taigy et al. (2013) Associations between drug use and sexual risks among heterosexual men in the Philippines. Int J STD AIDS 24:969-76

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