Risks for HIV Infection in Incarcerated Women

Abstract

The goal of this research was to investigate risks for exposure to human immunodeficiency virus (HIV) and a spectrum of gynecological comorbidity associated with HIV infection in a population of incarcerated women. Eighty-eight women were selected by HIV infection status and interviewed about HIV risk-taking behaviors, sexual history, and gynecological history. Absolute CD4+ T cell counts and Papanicolaou test results were abstracted from the women's medical charts. Women who reported a history of childhood sexual abuse were more likely to engage in activities that increase susceptibility to HIV infection and were 2.8 times more likely (90% CI = 1.2-6.3) to be infected with HIV, when compared to women who were not sexually abused as children. HIV seropositive women were more likely than HIV seronegative women to report a history of gynecological infection. Specifically, pelvic inflammatory disease, herpesvirus, vaginal candidiasis, and gonorrhea were increased among HIV seropositive women compared to HIV seronegative women, while syphilis, vaginal trichomoniasis, cervical chlamydia infection, and bacterial vaginitis were not increased. HIV infection and CD4+ T cell count under 200 were each associated with increased abnormal cervical cell morphology. Experiences that increase women's exposure to HIV infection and HIV-related gynecological comorbidity are extremely prevalent in the female prison population and should be targeted by psychosocial and medical interventions among populations where there is a high prevalence of HIV infection.