Self-Reported Sexually Transmitted Infections After Incarceration in Women with or at Risk for HIV in the United States, 2007-2017

Background: U.S. women who have been incarcerated report high rates of sexual risk behavior and sexually transmitted infections (STIs).Methods: We estimated the effect of incarceration on the time to first incident STI in a multicenter cohort of U.S. women with or at risk for HIV. We used marginal structural models to compare time to first self-reported gonorrhea, chlamydia, or trichomonas infection for nonincarcerated women and incarcerated women. Covariates included demographic factors, HIV status, sex exchange, drug/alcohol use, and prior incarceration.Results: Three thousand hundred twenty-four women contributed a median of 4 at-risk years and experienced 213 first incident STI events. The crude incidence of STIs was 3.7 per 100 person-years for incarcerated women and 1.9 per 100 person-years for nonincarcerated women. The weighted hazard ratio for incident STIs was 4.05 (95% confidence interval: 1.61-10.19).Conclusion: Women with or at risk for HIV in the United States who have recently experienced incarceration may be at increased STI risk.

Automated summary

Women in the United States who have been incarcerated report higher rates of sexual risk behavior and sexually transmitted infections; the study found that incarceration increases the incidence of first incident STIs; therefore, women who have recently experienced incarceration may be at increased risk of STIs.