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. 2018 Dec 18;18(1):1387.
doi: 10.1186/s12889-018-6304-x.

Potential drivers of HIV acquisition in African-American women related to mass incarceration: an agent-based modelling study

Joëlla W Adams  1 , Mark N Lurie  1 , Maximilian R F King  1 , Kathleen A Brady  2 , Sandro Galea  3 , Samuel R Friedman  4 , Maria R Khan  5 , Brandon D L Marshall  6
Affiliations

Potential drivers of HIV acquisition in African-American women related to mass incarceration: an agent-based modelling study

Joëlla W Adams et al. BMC Public Health. .

Abstract

Background: The United States has the highest incarceration rate in the world. Incarceration can increase HIV risk behaviors for individuals involved with the criminal justice system and may be a driver of HIV acquisition within the community.

Methods: We used an agent-based model to simulate HIV transmission in a sexual-contact network representing heterosexual African American men and women in Philadelphia to identify factors influencing the impact of male mass incarceration on HIV acquisition in women. The model was calibrated using surveillance data and assumed incarceration increased the number of sexual contacts and decreased HIV care engagement for men post-release. Incarceration of a partner increased the number of sexual contacts for women. We compared a counterfactual scenario with no incarceration to scenarios varying key parameters to determine what factors drove HIV acquisition in women.

Results: Setting the duration of male high-risk sexual behavior to two years post-release increased the number of HIV transmissions to women by more than 20%. Decreasing post-release HIV care engagement and increasing HIV acquisition risk attributable to sexually transmitted infections (STIs) also increased the number of HIV transmissions to women. Changing the duration of risk behavior for women, the proportion of women engaging in higher risk behavior, and the relative risk of incarceration for HIV-infected men had minimal impact.

Conclusion: The mass incarceration of African American men can increase HIV acquisition in African American women on a population-level through factors including post-release high-risk behaviors, disruption of HIV care engagement among formerly incarcerated men, and increased STI prevalence. These findings suggest that the most influential points of intervention may be programs seeking to reduce male risk behaviors and promote HIV care engagement post-release, as well as STI testing and treatment programs for recently incarcerated men, as well as women with incarcerated partners.

Keywords: African Americans; HIV; Inmate; Prisons; Sexual behavior; Systems analysis.

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Conflict of interest statement

Ethics approval and consent to participate

Not applicable, all data used within the study are publicly available.

Consent for publication

Not applicable

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
The impact of incarceration and partner incarceration for agents within the ABM model
Fig. 2
Fig. 2
HIV transmissions attributable to changing selected parameter from upper to lower bound valuea. aThe y-axis represents the number of HIV transmissions attributable to changing the selected parameter from lower to upper bound value. Calculated as the absolute difference in the mean number of HIV transmissions using values reported in Table 1. For the male duration of high risk behavior parameter this is equivalent to 449-(-25) =474
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References

    1. World Prison Brief . World Prison Population List, eleventh edition. In: Walmsley R, editor. Institute for Criminal Policy Research. 2015.
    1. Alexander M: The new Jim crow : mass incarceration in the age of colorblindness. New York Jackson, Tenn.: new press ; distributed by Perseus distribution; 2010.
    1. The Sentencing Project: Report of The Sentencing Project to the United Nations Human Rights Committee Regarding Racial Disparities in the United States Criminal Justice System. In.; 2013.
    1. Wildeman C, Wang EA. Mass incarceration, public health, and widening inequality in the USA. Lancet. 2017;389(10077):1464–1474. - PubMed
    1. Kearney MS, Harris BH, Jácome E, Parker L. Ten economic facts about crime and incarceration in the United States. The Hamilton Project. 2014. http://www.hamiltonproject.org/assets/legacy/files/downloads_and_links/v.... Accessed 11 Dec 2018.

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