Abstract

Background: Incarcerated men and women differ in their views on HIV prevalence rates and susceptibility and their ability to prevent HIV infection. The objective of this study was to assess sex and gender differences in HIV risk behaviors of inmates in order to better support the consideration of gender in the development of HIV prevention interventions for the incarcerated population.

Methods: A survey of 1819 inmates was conducted using a structured questionnaire. Self-reported HIV risk behaviors of 526 women and 1293 men during incarceration were compared. Bivariate analyses were done to identify gender differences in demographic characteristics and HIV risk behaviors. Logistic regression was used to determine factors associated with engaging in sexual intercourse in prison.

Results: Mean age was higher for women than men (p = 0.05), and >50% of participants were African Americans. More women than men reported that they engaged in sexual intercourse (p < 0.001); however, men were more likely to report anal sex (p < 0.001). There were no sex differences in injection drug use. Women who identified as bisexual or lesbian, those who had been currently incarcerated for at least 1 year, and those who received tattoos in prison were more likely to report sexual intercourse. The only independent risk factor identified for men was being currently incarcerated for at least 7 years.

Conclusions: There are gender differences in HIV risk behaviors of inmates during incarceration. The findings in this study suggest that inmates may benefit from gender-specific HIV interventions while incarcerated and in the community subsequent to release.