Effects of incarceration on risky Sex: focus group data from Two New England states

Background: Human Immunodeficiency Virus (HIV) risk and interpersonal violence are interconnected public health problems facing incarcerated women. Prison may provide an opportune time to conduct HIV prevention activities with high-risk women. Methods: This study used qualitative analysis to explore how incarceration affected women’s experiences of and thoughts about sex and sex risk. Twenty-one incarcerated women who had engaged in unprotected sex with a male in the 90 days prior to incarceration and experienced interpersonal violence in their lifetime participated in semi-structured focus groups at four women’s prison facilities in two New England States. Results: Themes that emerged from these focus groups include: a) incarceration increased sexual desire for some women but decreased it for others, b) education and exposure to women with HIV during incarceration increased women’s intentions to use condoms after release, c) women recognized that partners were often unfaithful while women were incarcerated, d) women felt empowered by mental health/substance use treatment and sobriety in prison, and e) practical difficulties of re-entry challenged women’s resolve to practice safe sex after release. Conclusion: Themes illuminate possible directions for public health interventions for this population at high risk for HIV.