Faculty Bibliography

Child sexual abuse is associated with substance use and sexual risk behaviors during adolescence and adulthood, but no known studies have documented associations across the life course in a nationally representative U.S. SAMPLE: We used the National Longitudinal Study of Adolescent to Adult Health to measure associations between child sexual abuse and substance use and sexual risk behaviors during adolescence, young adulthood, and adulthood among males and females (n = 11,820). Approximately 10% of females and 7% of males reported child sexual abuse. Associations with substance use were strongest during adolescence and lessened over time. Increased odds of sexual risk among those with a history of child sexual abuse remained consistent through the life course. Significant gender differences existed for some associations (e.g., adulthood multiple partners: males adjusted odds ratio (AOR) = 1.73, 95%CI:1.18, 2.53; females AOR = 1.11, 95%CI:0.79, 1.56). Trauma-informed prevention interventions should address child sexual abuse among both males and females to prevent substance use and sexual risk behavior throughout the life course.

BACKGROUND: Research on the association between antisocial personality disorder (ASPD) with comorbid mental disorders and sexually transmitted infection (STI)/HIV risk among inmates is scant despite the high prevalence of psychopathology and of STI/HIV in this population. METHODS: We used baseline data from Project DISRUPT, a cohort study conducted among incarcerated African American men (n = 207), to measure associations between ASPD and STI/HIV risk. We also conducted latent class analyses (LCAs) to identify subgroups defined by ASPD with comorbid stress, depression, and borderline personality disorder symptoms and measured associations between latent class membership and STI/HIV risk. RESULTS: Approximately 15% had ASPD and 39% reported depression. Controlling for sociodemographics, stress, and depression, ASPD was independently associated with illicit [AOR = 3.23, 95% confidence interval (CI): 1.18-8.87] and injection drug use (AOR: 5.49, 95% CI: 1.23-24.42) but not with sexual risk. LCAs suggested that those at high risk of ASPD were likely to experience co-morbid mental disorders. ASPD comorbid with these disorders was linked to drug and sex risk. CONCLUSIONS: STI/HIV prevention for inmates should incorporate diagnosis and treatment of ASPD and comorbid disorders, and interventions to address ASPD-related factors (e.g., impulsivity) that drive STI/HIV risk.

BACKGROUND: While new HIV infections have decreased in recent years, new infections are not decreasing among men who have sex with men (MSM), especially MSM of color. Studies have shown that, in general, people at risk for and living with HIV have increased interaction with the criminal justice system than the general population, but little is known about the relationship between criminal justice history and HIV risk among MSM. This study seeks to measure associations between recent and prior history of incarceration and HIV risk behavior and viral load in HIV-positive MSM. METHODS: The Veterans Aging Cohort Study Survey Sub study (VACS Survey) is an observational cohort of veterans living with HIV that began in 2002 that was designed to evaluate the role of alcohol use with clinical outcomes. We analyzed VACS Survey data from the 2011-2012 follow-up, and include men who reported having at least one male sex partner in the year prior to the survey and who provided data regarding incarceration history (N=487). The independent variable of interest is self-reported history of incarceration (recent, ever, or never), and the dependent variables are detectable viral load and HIVrisk behaviors: injection drug use (IDU), 2+ sexual partner in past 12 months, sex without a condom in the past 12 months, sex without a condom due to alcohol or drug use, and sex with partners who had other sexual partners. Covariates included age, race, education, relationship status, income, and homelessness. RESULTS: Participants had a mean age of 52 years (sd = 9.5) and included 292 (60%) African-American, 131 (27%) white, and 64 (13%) of other race/ethnicity. The prevalence of incarceration history was 40%. In both unadjusted and adjusted models for age, education, marital status, income, and homelessness, recent and prior incarceration versus no incarceration were strongly associated with having a detectable HIV viral load (recent adjusted odds ratio [AOR] 3.25 95% CI: 1.35-7.83; prior AOR: 3.30 95% CI: 1.84-5.91). Those with a history of incarceration also had significantly higher odds of past 12 month IDU (recent AOR 17.11, 95% CI: 2.78- 105.48; prior AOR 6.10, 95% CI 1.15-32.44). Recent and prior incarceration were strongly associated with having two or more sex partners (recent AOR 2.74, 95% CI: 1.25-6.02; prior AOR 1.71, 95% CI 1.11- 2.64) and engaging in sex without a condom due to alcohol (recent AOR 14.34, 95% CI: 3.17-64.74; prior AOR 8.30 95% CI: 2.25-30.63) or drug use (recent AOR 5.74 95% CI 1.83-18.03; prior 2.90 95% CI: 1.13-7.42 respectively) and with partners who had other partners (recent AOR 3.31, 95% CI: 1.42-7.72; prior AOR 2.62, 95% CI 1.47-4.68). CONCLUSIONS: Among HIV positive MSM, incarceration is linked with multiple proximate determinants of HIV transmission including detectable viral load, IDU and high risk sexual activity. This study highlights the importance of targeting this population for intervention following release from incarceration as a means of reducing new HIV infections

We evaluated the association between social support received from significant others, family, and friends and HIV-related sexual risk behaviors among African American men involved in the criminal justice system. Project DISRUPT is a cohort study among African American men released from prison in North Carolina (N = 189). During the baseline (in-prison) survey, we assessed the amount of support men perceived they had received from significant others, family, and friends. We measured associations between low support from each source (

PMCID:5359176

PMID: 28116586

ISSN: 1468-2869

CID: 2418352