Abstract
We analyzed data from a cohort of Black and Latino men who have sex with men (MSM) in order to identify correlates of prevalent and incident incarceration, including potential predictors related to their status as sexual and gender minorities (SGMs). Baseline and follow-up self-administered survey data were examined from Los Angeles County participants’ ages 18–45 years at enrollment who were either HIV negative or living with HIV, but recruited to over represent men who used drugs and men with unsuppressed HIV infection. Multivariable logistic regression models were developed to identify predictors of baseline incarceration history and of incident incarceration over study follow-up among 440 and 338 participants, respectively. Older age, Black race, low socioeconomic status, homelessness, stimulant use, and depression symptoms were associated with baseline incarceration history. The only SGM-related factor associated with baseline incarceration history was having experienced violence based on sexual orientation identity. Just one statistically significant, independent positive predictor of incident incarceration was identified: prior incarceration, whereas having four or more friends that could lend money was a statistically significant protective factor against incident incarceration. Fundamental Cause Theory provides a useful framework to explain identified predictors of incarceration. Addressing poverty, housing instability, inadequate access to health care, and their root causes is critical to reducing incarceration rates in this population, as is expanded access to both diversion and anti-recidivism programs and to evidence-based treatment for stimulant use disorders.
Highlights
1800 Los Angeles CA 90024 sshoptaw@mednet. ucla.edu mSTUDY maintains an extensive biobehavioral repository of self-reported quantitative data, as well as blood, viable cells, nails, mucosal fluids and other specimens from this behaviorally well-characterized cohort
Having experienced physical violence related to sexual identity (AOR = 2.09 95% confidence intervals (CIs): 1.19–3.69) was the only SGMrelated factor independently associated with incarceration history in the logistic model
Consistent with prior research on the general U.S population, we found that incarceration history was positively associated with public health insurance status, Black race/ethnicity, low income, recent stimulant use, and depression symptoms for Black and Latino men who have sex with men (MSM) in Los Angeles [24, 26, 36, 41, 43]
Summary
Data were obtained from the ongoing Men who have Sex with Men & Substance Use Cohort at UCLA Linking Infections, Noting Effects (mSTUDY) that began enrolling participants in February 2015. Base set of independent covariates from the baseline survey was selected based on literature indicating that they have been shown to be predictors of incarceration [24, 34, 36, 41–43] These included sociodemographic variables, social support, sexual behavior, substance use, and psychosocial measures. Based on our examination of bivariate associations with incarceration, we included a covariate for one question, “How many people can you borrow $50 from today?” We included two covariates relating to sexual behavior—total number of partners and reporting concurrent sexual partners in the last 6 months These behaviors have been positively associated with activities that are criminalized, such as commercial sex and substance use, or that may signal a need to engage in survival sex, which is often a response to poverty or substance misuse. These participants included individuals who identified with other terms (e.g., realness, butch queen, crossdresser) or who refused any gender label
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