We evaluated sex-related differences in HIV and criminal
justice (CJ) outcomes.
We quantified sex-related differences in criminal offenses,
incarcerations, and HIV outcomes among all HIV-infected inmates on
antiretroviral therapy (ART) in Connecticut (2005-2012). Computed criminogenic
risk scores estimated future CJ involvement. Stacked logistic regression models
with random effects identified significant correlates of HIV viral suppression
on CJ entry, reflecting preceding community-based treatment.
Compared with 866 HIV-infected men on ART (1619
incarcerations), 223 women (461 incarcerations) were more likely to be younger,
White, and medically insured, with shorter incarceration periods (mean = 196.8
vs 368.1 days), mostly for public disorder offenses. One third of both women
and men had viral suppression on CJ entry, correlating positively with older
age and having treated comorbidities. Entry viral suppression inversely
correlated with incarceration duration for women and with criminogenic risk
score for men.
In the largest contemporary cohort of HIV-infected inmates
on ART, women's higher prevalence of nonviolent offenses and treatable
comorbidities supports alternatives to incarceration strategies. Sex-specific
interventions for CJ populations with HIV effectively align public health and
safety goals.
Table 1
Descriptive Characteristics of HIV-infected Individuals (N=1089) and Incarceration Periods (N=2080), Stratified by Sex
| Individuals | Total Sample N=1089 | Men N=866 | Women N=223 | p-value1 |
|---|---|---|---|---|
| Mean age, years (SD) | 42.6 (8.4) | 43.3 (8.5) | 40.2 (7.1) | <0.001 |
| Race/ethnicity, n (%) | <0.001 | |||
| White, non-Hispanic | 218 (20.0) | 149 (17.1) | 69 (31.0) | |
| Black, non-Hispanic | 515 (47.3) | 411 (47.5) | 104 (46.6) | |
| Hispanic | 351 (32.2) | 303 (35.0) | 48 (21.5) | |
| Other | 5 (0.5) | 3 (0.4) | 2 (0.9) | |
| Married, n (%) | 179 (16.4) | 149 (17.2) | 30 (13.5) | 0.18 |
| Dependent children, n (%) | 0.21 | |||
| None | 400 (36.7) | 310 (35.8) | 90 (40.4) | |
| At least one | 689 (63.3) | 556 (64.2) | 133 (59.6) | |
| Education, n (%) | 0.28 | |||
| High school or less | 502 (46.1) | 392 (45.3) | 110 (49.3) | |
| At least high school | 587 (53.9) | 474 (54.7) | 113 (50.7) | |
| Ever had medical insurance on entry, n (%) | 194 (17.8) | 79 (9.1) | 115 (51.6) | <0.001 |
| Incarceration Periods | Total N=2080 | Men N=1619 | Women N=461 | p-value |
|---|---|---|---|---|
| Mean number incarceration periods per person (SD) | 1.9 (1.4) | 1.9 (1.4) | 2.1 (1.4) | 0.06 |
| Duration incarceration, days | <0.001 | |||
| Mean (SD) | 330.1 (473.4) | 368.1 (510.6) | 196.8 (269.7) | |
| Median (IQR) | 166.5 (304) | 182 (383) | 96 (222) | |
| Number of inter-facility transfers (%) | 0.05 | |||
| Zero | 1954 (93.9) | 1512 (93.4) | 442 (95.9) | |
| ≥ One | 126 (6.1) | 107 (6.6) | 19 (4.1) | |
| Time spent in community between incarceration periods, days2 | ||||
| Mean (SD) | 325.9 (357.7) | 323.1 (353.3) | 334.6 (317.9) | 0.30 |
| Median (Min, Max) | 194.5 (1,2069) | 190.5 (1,2069) | 208 (5,2064) | 0.68 |
| Intake Year, n (%) | <0.001 | |||
| 2005-2007 | 1025 (49.3) | 759 (46.9) | 266 (57.7) | |
| 2008-2010 | 803 (38.6) | 655 (40.5) | 148 (32.1) | |
| 2011-2012 | 252 (12.1) | 205 (12.7) | 47 (10.2) | |
| Discharge status, n (%) | 0.22 | |||
| Probation/parole | 679 (32.6) | 533 (32.9) | 146 (31.7) | |
| Release | 1384 (66.6) | 1070 (66.1) | 314 (68.1) | |
| Death | 17 (0.8) | 16 (1.0) | 1 (0.2) | |
| Re-incarceration rate3 | 0.006 | |||
| Mean (SD) | 0.63 | 0.67 (1.0) | 0.47 (0.38) | |
| Median (IQR) | 0.41 (0.22-0.72) | 0.42 (0.23-0.75) | 0.38 (0.20-0.60) | |
1Using Student's t-test for continuous variables and Chi-squared test for categorical variables unless otherwise noted
2For individuals with more than one incarceration during the observation period
3By Wilcoxon rank sum
Full article at: http://goo.gl/4zeF2K
- 1Jaimie P. Meyer and Frederick L. Altice are with the AIDS Program, Yale School of Medicine, New Haven, CT. Jaimie P. Meyer is also with the Chronic Disease Epidemiology Department, Yale School of Public Health, New Haven. Javier Cepeda and Frederick L. Altice are with the Department of Epidemiology of Microbial Diseases, Yale School of Public Health. Faye S. Taxman is with the Criminology, Law, and Society Department, George Mason University, Fairfax, VA.
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