HIV risk behaviors and their relationship to posttraumatic stress disorderamong women prisoners

Objective: This study assessed HIV risk behaviors and their association wit h psychiatric disorders among women prisoners. Methods: HIV risk behaviors practiced in the five years before incarceration were ascertained with the Risk Behavior Assessment interview for 177 inmates at the Maryland Correcti onal Institution for Women. The Structured Clinical Interview for the DSPM- IV was used to determine the occurrence of postraumatic stress disorder (PT SD), major depression, and dysthymic disorder among the women. Regression m odels were used ito determine the association between HIV risk behavior and psychiatric disorders. Results: HN risk behaviors in the five years before incarceration included never or rarely having used condoms (56 percent of the women), injection drug use (42 percent), sexual intercourse with a part ner who used injection drugs (42 percent), prostitution (30 percent), needl e sharing (30 percent), receptive anal sex (19 percent), and having more th an 100 sex partners (7 percent). After the analysis adjusted for age, educa tion, race, HIV status, and addictive disorders, a lifetime occurrence of P TSD was associated with the practice of anal sex (odds ratio = 1.7; 95 perc ent confidence interval = 1.26 to 2.16; p < .02) and prostitution (OR = 1.5 6; 95% CI = 1.17 to 1.95; p < .03). Conclusions: HIV risk behaviors before incarceration were highly prevalent among the women in this study Rates of PTSD, depression, and dysthymic disorder were also high. PTSD was associate d with prostitution and receptive anal sex, and the disorder may contribute to high rates of risky sexual behavior. Targeted HIV risk reduction effort s among women prisoners should include evaluation for PTSD; conversely, wom en prisoners with a diagnosis of PTS;D should be evaluated for prior HIV se xual risk behaviors.