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Sexual health prevention for incarcerated women: eroticising safe sex during re-entry to the community
  1. Caroline C Kuo1,2,
  2. Rochelle K Rosen3,4,
  3. Caron Zlotnick5,
  4. Wendee M Wechsberg6,
  5. Marlanea Peabody7,
  6. Jennifer E Johnson8
  1. 1 Department of Behavioral and Social Sciences, Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, Rhode Island, USA
  2. 2 Department of Psychiatry and Mental Health, University of Cape Town, Providence, Rhode Island, USA
  3. 3 Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, Rhode Island, USA
  4. 4 Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island, USA
  5. 5 Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Women and Infants Hospital, Butler Hospital, Providence, Rhode Island, USA
  6. 6 Substance Abuse Treatment Evaluations and Interventions, RTI International, Research Triangle Park, North Carolina, USA
  7. 7 Brown University School of Public Health, Providence, Rhode Island, USA
  8. 8 Division of Public Health, College of Human Medicine, Michigan State University, Flint, Michigan, USA
  1. Correspondence to Dr Caroline C Kuo, Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI 02903, USA; caroline_kuo{at}brown.edu

Abstract

Introduction In the USA, incarcerated women are disproportionately affected by sexually transmitted infections (STIs) including HIV. Transitioning from incarceration into the community is accompanied by elevated risk behaviours related to acquisition of STIs, yet few efficacious interventions address sexual health prevention among incarcerated women.

Methods We conducted an exploratory qualitative study with 21 incarcerated women at four women’s state prison facilities in two Northeastern states in the USA. Qualitative data were gathered from four focus groups to guide future intervention development. Focus group discussions were guided by a semi-structured protocol exploring perceptions of sexual health prevention methods, experience with implementing prevention technologies and protective behaviours, and strategies to overcome challenges in implementing sexual health prevention behaviours. Focus groups were audio-recorded and transcribed verbatim. Data were analysed using thematic analysis.

Results Women described challenges in uptake of existing low-cost sexual health prevention strategies such as condoms. They identified strategies to facilitate use of prevention tools, and to increase protective behaviours relating to sexual health during the transition from incarceration to the community. For example, women described methods for eroticising male and female condoms, including selecting condoms with novel features, explaining to partners that condoms could increase sexual pleasure, and incorporating condom application into foreplay and/or oral sex.

Conclusion Incorporating these insights, including how to eroticise safe sex, can inform the design of future preventive interventions tailored to meet the urgent sexual health needs of incarcerated women preparing for reintegration into the community.

Clinical trial registration NCT01907126.

  • incarcerated women
  • hiv risk
  • STI
  • sexual experience
  • qualitative research

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Footnotes

  • Contributors All authors contributed significantly to the manuscript. JEJ and CZ were responsible for the design and execution of the study. JEJ, RKR, CZ and WMW contributed to study design, data collection, analysis and writing. CCK and MP contributed to data collection, analysis and writing, with CCK taking the lead on this manuscript’s analysis and writing.

  • Funding This research was supported by funding from the National Institute for Mental Health Grant Number R34 MH094188 (PI: Johnson, Zlotnick; Co-I: Rosen, Wechsberg). Additional support for publication was supported by funding from the National Institute for Mental Health Grant Number K01 MH096646 and L30 MH098313 (PI: Caroline Kuo). NIH had no input into the analysis or content of this article.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval Brown University.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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