Andrea K Knittel1, Jacqueline E Rudolph2, Bonnie E Shook-Sa3, Andrew Edmonds2, Catalina Ramirez4, Mardge Cohen5, Tonya Taylor6, Adebola Adedimeji7, Katherine G Michel8, Joel Milam9, Jennifer Cohen10, Jessica D Donohue11, Antonina Foster12, Margaret A Fischl13, Dustin M Long14, Adaora A Adimora4. 1. Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA. 2. Department of Epidemiology, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina, USA. 3. Department of Biostatistics, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina, USA. 4. Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina. USA. 5. Stroger Hospital, Chicago, Illinois, USA. 6. Division of Infectious Disease, College of Medicine at SUNY Downstate Medical Center, Brooklyn, New York, USA. 7. Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA. 8. Department of Infectious Diseases, Georgetown University School of Medicine, Washington, District of Columbia, USA. 9. Department of Preventive Medicine, University of Southern California, Los Angeles, California, USA. 10. Department of Medicine, University of California San Francisco, San Francisco, California, USA. 11. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA. 12. Division of Infectious Disease, Department of Medicine, Emory University, Atlanta, Georgia, USA. 13. Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida, USA. 14. Department of Biostatistics, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Abstract
Background: U.S. women who have been incarcerated report high rates of sexual risk behavior and sexually transmitted infections (STIs). Materials and 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.
Background: U.S. women who have been incarcerated report high rates of sexual risk behavior and sexually transmitted infections (STIs). Materials and 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.
Entities:
Keywords:
STI; chlamydia; gonorrhea; incarceration; trichomonas; women
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