Incarceration and Sexual Risk: An Examination of How Incarceration Shapes the Context of HIV Risk.

Abstract

This dissertation introduces a conceptual framework theorizing that incarceration and the inequities inherent in the current criminal justice system in the United States render changes in individual sexual decision-making among those incarcerated and their partners that ultimately increase community HIV risk, and offers evidence to support this theory.

Chapter two examines the patterns of sexual behavior of a nationally representative sample of young men, comparing those who have been incarcerated to those who have not. A key finding is that men who have been incarcerated have higher lifetime rates of partnership, and are more likely to have partners with concurrent partners. This analysis also compares these two groups of young men at a point before adult incarceration, and finds that prior to incarceration there were very few significant differences between these groups, adding strength to the argument for a causal relationship between incarceration and riskier sexual behavior.

In chapter three, I develop and describe an agent-based model of sexual partnership and behavior, ultimately validating that the methodology has value for testing hypotheses about the link between individual-level partnering behavior and community-level sexual networks. The model generates rates of partnership and concurrency, as well as measures of relationship duration and similarity between sexual partners that match the findings of empirical data from the United States.

Chapter four extends the model to include incarceration and presents a series of model experiments that explore how rates of incarceration, the specific effects of incarceration on sexual partnerships, and other community characteristics interact to determine sexual partnership dynamics. Model results demonstrate increases in the number of sexual partners in the community, distinct from the effects of incarceration on incarcerated agents. These results provide “proof of principle” that incarceration may explain part of the differences observed between patterns of sexual behavior in communities with low rates of incarceration and those with high rates.

Finally, the fifth and concluding chapter synthesizes these results and proposes a research program based on these findings. It highlights the need for further investigation into the process through which incarceration shapes sexual behavior, for those individuals who are incarcerated, and their partners.