Drug use and HIV among Men in Community Correction Programs and Their Female Primary Sex Partners
Although approximately seven million people are in community supervision programs, research on HIV and drug use remains limited. Project PACT is one of a few studies that specifically targets this rare population and provides a deep insight into drug use and sexual behaviors not only among men in community supervision, but also their female primary sex partners.
Background to PACT Study
Ron was in jail for several years. During that time, his primary girlfriend Shana stuck by his side, despite their frequent arguments. After all, they had a child to consider. Now Ron was in a Community Supervision program, yet both Ron and Shana reported feeling alone and scared. Shana said she felt like they both did time and were still recovering. The challenges for this family were many. As former substance-involved individuals with a high risk for acquiring an STI or HIV, they both knew extra work was needed to remain healthy.
While Ron and Shana are fictitious characters, they represent many stories discovered during the years of the PACT study conducted here at the Social Intervention Group (SIG). Couples like Ron and Shana and families feel the impact of existing within the criminal justice system. When asked to draw how the system fits into their lives, many couples in the study drew bars and images depicting fear.
This is the first paper from the PACT study that is designed to examine the effectiveness of couple-based HIV prevention for men and their within community corrections and their primary female sex partners. This phase of the study included a total of 1167 participants: 822 males and 345 of their female sex partners (not all of the men invited their female sex partners to participate in the study).
PACT Study Findings and Methodology
The findings show that a little over half of those studied were African American. Hispanics accounted for about a quarter of the cases, while less than 10% were non-Hispanic Caucasians. Most men use marijuana, less than 10% use other illicit drugs.
The numbers of African American men in the study are unsurprising given that community correction programs in New York City are filled with African American men. Though definitive data on reasons for participant arrest is lacking, the PACT findings indicate that people of color, primarily African American individuals, are arrested for marijuana possession and other minor drug charges more frequently than non-Hispanic Caucasians, which is consistent with what has been extensively shown in New York City and across the US.
The paper used a Latent Class Analysis (LCA), which is a statistical method for identifying unmeasured class membership among subjects using categorical and/or continuous observed variables. This paper identifies typologies -- a classification according to general type -- of drug use among men in community correction programs in New York City and among their female primary sex partners.
The paper found that there were three typologies of drug use for both men and their female primary sex partners: (1) polydrug use, (2) mild polydrug users with severe alcohol and marijuana use, and (3) alcohol and marijuana users. Non -Hispanic Caucasians were significantly more likely to be in the polydrug use cluster (marijuana and other illicit drugs) than other racial/ethnic groups.
Polydrug users and mild polydrug users were more likely to have risky sex partners and higher rates of criminal justice involvement than alcohol and marijuana users. This information can be used to inform HIV and drug treatment interventions. Thus, HIV and substance use interventions should particularly focus on polydrug users as they are higher risk.
Given that the men were willing to recruit and successfully bring in their female primary sex partners to participate in the study, a couple-based HIV prevention approach and linkage to drug use services may be appropriate, where both can receive the intervention together. Couple-based approaches may serve this population well, given that both drug-using clusters and both genders reported significant risks for HIV and continued drug use.
As the abstract concludes:
Community correction programs could be the venue to provide better access by reaching out to this high HIV risk key population with increased rates of drug use and multiple sex partners.
The PACT study is funded by NIDA to Dr. Nabila El-Bassel and co-investigators at SIG including Drs. Louisa Gilbert and Elwin Wu, in collaboration with Drs. Timothy Hunt and Dawn Goddard-Eckrich. The study conduct in collaboration with Alissa Davis, Amar Mandavia, Phillip Marotta, and Mingway Chang.
Men in Community Correction Programs and Their Female Primary Sex Partners: Latent Class Analysis to Identify the Relationship of Clusters of Drug Use and Sexual Behaviors and HIV Risks
Link to publication
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