Sexually Transmitted Infection Risk Among African American Men in Committed Heterosexual Partnerships Disrupted By Incarceration

Background: Incarceration may contribute to sexually transmitted infection (STI) by disrupting committed partnerships. Research describing partnerships disrupted by incarceration is limited.

Methods: Project DISRUPT is an ongoing cohort study among African American men being released from prison in North Carolina who were in primary committed heterosexual partnerships at the time of incarceration. Baseline survey data collected just prior to release from incarceration (N=169) were analyzed to identify aspects of partnerships associated with protection against pre-incarceration sexual risk-taking and baseline infection with chlamydia, gonorrhea, or trichomoniasis. These STIs, not routinely assessed at prison intake, were measured just prior to release using urine-based nucleic acid amplification assays. 

Results: The median relationship length was 3 years, 15% were married, 57% lived together before incarceration, 62% raised a child with their partners, and 32% reported being “very happy” in the relationship. Substantial proportions reported multiple (47%) and concurrent (36%) partnerships, paying for sex (9%), and anal sex with any partner (21%) in the six months before incarceration. Approximately 7% tested positive for a STI at baseline (3.2% trichomoniasis; 3.6% chlamydia; 0.6% gonorrhea). Odds of multiple partnerships were lower among married (OR: 0.17, 95% CI: 0.06-0.52) and cohabitating (OR: 0.50, 95% CI: 0.25-0.99) participants and among those who had been with partners for more than 3 years (OR: 0.44, 95% CI: 0.23-0.84). Being “very happy” in the relationship versus “happy” or “unhappy” was associated with lower levels of multiple (OR: 0.44, 95% CI: 0.23-0.84) and concurrent (OR: 0.42, 95% CI: 0.21-0.82) partnerships; however, relationship satisfaction also was associated with elevated odds of anal sex (OR: 2.34, 95% CI: 1.11-5.01). Relationship characteristics were not associated with prevalent STI.

Conclusions: Partnerships characterized by higher levels of relationship satisfaction and commitment conferred greater protection against STI-related risk behaviors except anal sex among incarcerated men in committed heterosexual partnerships.