P817 Longitudinal associations between recent incarceration and STI/HIV risk: the role of prior trauma in exacerbating risk. (14th July 2019)

• Record Type: Journal Article
• Authors: Young, Kailyn; Mei, Willem Van Der; Scheidell, Joy; Dyer, Typhanye; Hucks-Ortiz, Christopher; Brewer, Russell; Severe, Macregga; Troxel, Andrea; Kaufman, Jay; Khan, Maria
• Is Part Of: Sexually transmitted infections. Volume 95(2019)Supplement 1
• Page Start: A344
• Page End: A344
• Publication Date: 2019-07-14
• Subjects: vulnerable populations -- risk factors -- trends; Sexually transmitted diseases -- Periodicals; HIV infections -- Periodicals; 616.951005
• DOI: 10.1136/sextrans-2019-sti.863
• Languages: English
• ISSNs: 1368-4973

Abstract

Abstract : Background: Black men who have sex with men (BMSM) disproportionately report a history of traumatic life events including incarceration. Incarceration, by increasing distress and psychopathology, may increase risk-taking and infection. Pre-incarceration trauma may exacerbate the impact of incarceration on STI/HIV risk among BMSM. Methods: Using data from HIV Prevention Trials Network (HPTN) 061, we used inverse probability of treatment weighted Poisson regression models to estimate risk ratios (RRs) and 95% confidence intervals (CIs) for associations between recent incarceration and incident STI (gonorrhea, chlamydia, and syphilis) and sexual risk behavior (sex trade defined as selling/buying sex, multiple partnerships, condomless sex) measured six months after incarceration assessment (n=1189). We tested the significance of interaction terms between incarceration and trauma to assess whether associations differed significantly by trauma history (e.g., experiencing a robbery, natural disaster, sexual/physical assault). Results: Approximately 93% reported at least one traumatic event and 14% had been recently incarcerated. Incarceration was associated with STI among those with prior trauma (RR: 1.10, 95% CI: 1.00–1.22) but not among those with no prior trauma (RR: 0.91, 95% CI: 0.75–1.09); associations differed significantly (interaction term p=0.036). Incarceration was linked to increased risk of sex trade involvement among those with prior trauma (RR: 1.08, 95% CI: 1.00–1.15) and decreased risk among those with no prior trauma (RR: 0.95, 95% CI: 0.90–1.00) (interaction term p=0.002). Incarceration was associated with increased risk of multiple partnerships among those with prior trauma (RR: 1.24; CI: 1.10, 1.40) but not among those with no prior trauma (RR: 0.85, 95% CI: 0.32–2.25), though the RRs were not significantly different (interaction term p=0.224). Incarceration was not associated with condomless sex, regardless of prior trauma. Conclusion: BMSM with prior trauma appear to face disproportionate vulnerability to STI/HIV risk after release from incarceration. Trauma-informed STI/HIV care and prevention interventions for BMSM with recent justice involvement are warranted. Disclosure: No significant relationships.