Incarceration and unstable housing interact to predict sexual risk behaviours among African American STD clinic patients

Laura Widman, Seth M. Noar, Carol E. Golin, Jessica F. Willoughby, Richard Crosby

Research output: Contribution to journalArticlepeer-review

19 Scopus citations


Given the dramatic racial disparities in the rates of HIV/sexually transmitted infections (STIs) among African Americans, understanding broader structural factors that increase the risk for HIV/STIs is crucial. This study investigated incarceration history and unstable housing as two structural predictors of HIV risk behaviour among 293 African Americans (159 men/134 women, mean age = 27). Participants were recruited from an urban sexually transmitted disease (STD) clinic in the southeastern U.S. Approximately half the sample had been incarcerated in their lifetime (54%), and 43% had been unstably housed in the past six months. Incarceration was independently associated with the number of sex partners and the frequency of unprotected sex. Unstable housing was independently associated with the frequency of unprotected sex. However, these main effects were qualified by significant interactions: individuals with a history of incarceration and more unstable housing had more sex partners and more unprotected sex in the past three months than individuals without these structural barriers. Implications for structural-level interventions are discussed.

Original languageEnglish
Pages (from-to)348-354
Number of pages7
JournalInternational Journal of STD and AIDS
Issue number5
StatePublished - Apr 2014

Bibliographical note

Funding Information:
This work was supported by a Research Support Grant from the Office of the Vice President for Research and funds from the College of Communications and Information Studies at the University of Kentucky. This work was also supported in part by funding from NIH/NIAID 5 T32 AI07001-34: Training in Sexually Transmitted Diseases and HIV, support from the National Center for Research Resources and the National Center for Advancing Translational Sciences (NIH grant UL1TR000083), and support from the UNC Center for AIDS Research (NIH grant P30AI50410).


  • housing
  • incarceration
  • racial disparities
  • sexual risk behaviour
  • sexually transmitted infections
  • structural factors

ASJC Scopus subject areas

  • Dermatology
  • Public Health, Environmental and Occupational Health
  • Pharmacology (medical)
  • Infectious Diseases


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