HIV Sexual Risks Among Older Women On Probation and Parole

Background and Purpose: Numerous studies indicate that criminal justice involvement and HIV risk are complex, interconnected concerns.  In contrast to findings among men and women in the general population, women who are incarcerated, on probation, or on parole, generally have higher rates of HIV than their male counterparts.  Women involved in the criminal justice system also have considerably higher rates of HIV than women in the general population.  While emerging research is beginning to address HIV risk and prevention among adults on probation and parole, there remains a need to examine HIV sexual risk behaviors among older women in this group.  This study aims to address this critical gap in knowledge in order to guide developmentally-informed HIV prevention efforts.

Methods: A total of 334 women on probation and parole in an urban county in the southern U.S. were recruited primarily through flyers in public locations and direct mailings.  Participants completed structured interviews with female interviewers and entered their responses using audio computer-assisted interview technology.  HIV sexual risk behaviors were measured via self-reports to study-designed questions and were compared among younger (19-34), mid-life (35-44), and older (45-69) women in bivariate analyses.

Results:  Participants were predominantly African American (41%) and Caucasian (51%); they were single (40%), separated/divorced (36%), living with a female partner (13%) or married/living with a male partner (11%).  Their ages ranged from 19-69 (mean= 37.4 years, SD=10.3).  More than 80% of the women had less than $1000.00 in income during the last month.  Of the 222 women who reported vaginal sex in the last 90 days, 81% reported inconsistent condom use.  Inconsistent condom use was also high with anal (92%) and oral (90%) sex.  While older women were statistically-significantly less likely to report vaginal, anal or oral sex in the last 90 days, those who did engage in sexual activity were as likely to report inconsistent condom use as women in the younger groups.  Additionally, there were no statistically-significant differences in their number of lifetime or recent sexual partners or in their number of recent sexual partners who use injection drugs.  Older women were more likely to report a lifetime history of sex trading than younger women.  They were also more likely to report sex trading in the last year than mid-life women, but less likely than the youngest women.  Older women began trading sex later in life and were involved in sex trading for a longer period of time than younger women.

Conclusions and Implications:  Though they report less sexual activity, older women on probation and parole who are sexually active report HIV sexual risks that are comparable to younger women.  Future research would benefit from age-specific evaluation of HIV prevention efforts among this group of women, who remain at risk into later life.  The longer period of time that older women have engaged in trading sex may increase their potential for physical and psychological risks associated with sex trading and should be considered in HIV prevention and other health and social services with this population.