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Objectives. To assess police contact as a potential adverse childhood experience by measuring its prevalence, nature, and distribution among urban adolescents. Methods. Detailed US population-based data on youthâpolice contact were collected in the Fragile Families and Child Wellbeing Study (n = 2478) from 2014 to 2017. Using regression modeling, I assessed adolescents' police exposure and the magnitude and robustness of racial disparities in police contact. Sensitivity analyses examined disparities by behavior and socioeconomic context. Results. Urban youths are heavily policed, beginning in preadolescence. Exposure to policing is unevenly distributed, with non-White adolescents-particularly Black boys-reporting more, and more aggressive, contact than their White counterparts. HispanicâWhite differences and disparities in girls' experiences were less pronounced but present, particularly in how intrusive stops were. Intrusion disparities were robust to most behavioral controls, but not observed among youths with higher socioeconomic status. Conclusions. Given extant literature documenting adverse health consequences of police encounters, findings implicate policing as a driver of health disparities in adolescence and throughout the life course. Public health infrastructure dedicated to the prevention and treatment of adverse childhood experiences is well suited for mitigating these harms and inequities.
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Experiências Adversas da Infância/etnologia , Polícia/estatística & dados numéricos , Adolescente , Comportamento do Adolescente , Criança , Feminino , Disparidades nos Níveis de Saúde , Humanos , Masculino , Prevalência , Meio Social , Fatores Socioeconômicos , População UrbanaRESUMO
Interactions with the police may result in police brutality, particularly for people of color. Black men who have sex with men (BMSM) face disproportionate risk of police contact and may experience elevated violence risk. We measured longitudinal associations between discriminatory police harassment (DPH) and subsequent risk of a range of interpersonal violence experiences, including intimate partner violence (IPV). In this study, we estimated associations between DPH motivated by racism, homophobia, or both, and subsequent violent experiences (being physically harassed, hit, threatened with weapons, and intimate partner violence) among BMSM. Bivariate and multivariable regression analyses were used to control for demographic and behavioral factors. Among 1160 BMSM included at 12-month follow-up, experiencing DPH motivated by racism and homophobia was associated with over four times the odds of being threatened with violence (AOR 4.85, 95% CI 3.20, 7.33), four times the odds of or experiencing violence defined as being punched, kicked, or beaten, or having an object thrown at them (AOR 4.51, 95% CI 2.82, 7.19), and nearly three times the odds of physical partner abuse (AOR 3.49, 95% CI 1.69, 7.19). Findings suggest that for BMSM, DPH is associated with the threat and experience of violence, with a dose-response relationship between DPH motivated by one or more causes. Given that BMSM are a population particularly vulnerable to both police harassment related to race and sexual orientation and violence coupled with stigma, additional research evaluating mechanisms linking these associations is needed in order to develop additional supportive interventions.
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Violência por Parceiro Íntimo , Minorias Sexuais e de Gênero , Negro ou Afro-Americano , Cidades , Feminino , Homossexualidade Masculina , Humanos , Masculino , Polícia , ViolênciaRESUMO
BACKGROUND: Three months after the first reported cases, COVID-19 had spread to nearly 90% of World Health Organization (WHO) member states and only 24 countries had not reported cases as of 30 March 2020. This analysis aimed to 1) assess characteristics, capability to detect and monitor COVID-19, and disease control measures in these 24 countries, 2) understand potential factors for the reported delayed COVID-19 introduction, and 3) identify gaps and opportunities for outbreak preparedness, particularly in low and middle-income countries (LMICs). We collected and analyzed publicly available information on country characteristics, COVID-19 testing, influenza surveillance, border measures, and preparedness activities in these countries. We also assessed the association between the temporal spread of COVID-19 in all countries with reported cases with globalization indicator and geographic location. RESULTS: Temporal spreading of COVID-19 was strongly associated with countries' globalization indicator and geographic location. Most of the 24 countries with delayed COVID-19 introduction were LMICs; 88% were small island or landlocked developing countries. As of 30 March 2020, only 38% of these countries reported in-country COVID-19 testing capability, and 71% reported conducting influenza surveillance during the past year. All had implemented two or more border measures, (e.g., travel restrictions and border closures) and multiple preparedness activities (e.g., national preparedness plans and school closing). CONCLUSIONS: Limited testing capacity suggests that most of the 24 delayed countries may have lacked the capability to detect and identify cases early through sentinel and case-based surveillance. Low global connectedness, geographic isolation, and border measures were common among these countries and may have contributed to the delayed introduction of COVID-19 into these countries. This paper contributes to identifying opportunities for pandemic preparedness, such as increasing disease detection, surveillance, and international collaborations. As the global situation continues to evolve, it is essential for countries to improve and prioritize their capacities to rapidly prevent, detect, and respond, not only for COVID-19, but also for future outbreaks.
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COVID-19/epidemiologia , Surtos de Doenças/prevenção & controle , Saúde Global , Pandemias/prevenção & controle , Vigilância em Saúde Pública , COVID-19/diagnóstico , COVID-19/prevenção & controle , Teste para COVID-19/estatística & dados numéricos , Humanos , Influenza Humana/epidemiologia , Viagem/legislação & jurisprudência , Organização Mundial da SaúdeRESUMO
School-based surveys provide a useful method for gathering data from youth. Existing literature offers many examples of data collection through school-based surveys, and a small subset of literature describes methodological approaches or general recommendations for health promotion professionals seeking to conduct school-based data collection. Much less is available on real-life logistical challenges (e.g., minimizing disruption in the school day) and corresponding solutions. In this article, we fill that literature gap by offering practical considerations for the administration of school-based surveys. The protocol and practical considerations outlined in the article are based on a survey conducted with 11,681 students from seven large, urban public high schools in the southeast United States. We outline our protocol for implementing a school-based survey that was conducted with all students school-wide, and we describe six types of key challenges faced in conducting the survey: consent procedures, scheduling, locating students within the schools, teacher failure to administer the survey, improper administration of the survey, and minimizing disruption. For each challenge, we offer our key lessons learned and associated recommendations for successfully implementing school-based surveys, and we provide relevant tools for practitioners planning to conduct their own surveys in schools.
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Inquéritos Epidemiológicos/métodos , Instituições Acadêmicas , Adolescente , Criança , Promoção da Saúde , Humanos , Sudeste dos Estados UnidosRESUMO
More than 2 million American children have a parent incarcerated, making the consequences of parental incarceration for families critical to understand. A growing literature documents significant challenges not only among incarcerated men, but also among their spouses, partners, and children. Much remains to be learned about these experiences; however, and the data available for doing so are limited. This analysis takes steps to improve the quality of available data on paternal incarceration by supplementing a leading population-based survey of families with administrative criminal history records from a state criminal justice agency. While this administrative supplement provides only a lower-bound on the extent of criminal justice involvement in our sample, it increases the number of fathers identified with criminal histories by more than 20%. Building upon such a supplement, in our current survey or future ones, stands to improve the identification of justice-involved fathers on a broader scale.
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OBJECTIVES: We surveyed young men on their experiences of police encounters and subsequent mental health. METHODS: Between September 2012 and March 2013, we conducted a population-based telephone survey of 1261 young men aged 18 to 26 years in New York City. Respondents reported how many times they were approached by New York Police Department officers, what these encounters entailed, any trauma they attributed to the stops, and their overall anxiety. We analyzed data using cross-sectional regressions. RESULTS: Participants who reported more police contact also reported more trauma and anxiety symptoms, associations tied to how many stops they reported, the intrusiveness of the encounters, and their perceptions of police fairness. CONCLUSIONS: The intensity of respondent experiences and their associated health risks raise serious concerns, suggesting a need to reevaluate officer interactions with the public. Less invasive tactics are needed for suspects who may display mental health symptoms and to reduce any psychological harms to individuals stopped.
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Saúde Mental , Polícia , Adolescente , Adulto , Transtornos de Ansiedade/epidemiologia , Demografia , Humanos , Entrevistas como Assunto , Masculino , Cidade de Nova Iorque/epidemiologia , Vigilância da População , Transtornos de Estresse Pós-Traumáticos/epidemiologia , População UrbanaRESUMO
OBJECTIVE: Evaluate associations between racialized and homophobia-based police harassment (RHBPH) and healthcare distrust and utilization among Black Sexual Minority Men (BSMM). METHODS: We utilized data from a longitudinal cohort study from HIV Prevention Trials Network (HPTN) 061 with baseline, six and 12 month follow-up assessments. Using multivariable analysis, we evaluated associations between RHBPH and healthcare distrust and utilization reported at the 6 and 12 month visits. RESULTS: Of 1553 BSMM present at baseline, 1160 were available at six-month follow-up. In multivariable analysis, increasing frequency of RHBPH was associated with increasing levels of distrust in healthcare providers (aOR 1.31, 95% CI: 1.00, 1.74) and missing 50% or more of healthcare visits at six-month follow-up (aOR 1.93, 95% CI: 1.09, 3.43). CONCLUSIONS: Recent experiences of RHBPH are associated with reduced trust in and access to healthcare among BSMM, with more frequent RHBPH associated with greater vulnerability.
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Infecções por HIV , Minorias Sexuais e de Gênero , Masculino , Humanos , HIV , Estudos Longitudinais , Polícia , Infecções por HIV/epidemiologia , Atenção à SaúdeRESUMO
Police contact is increasingly recognized as an adverse childhood experience and determinant of poor mental health. While targeting of LGBTQ sex and community spaces by law enforcement has a long precedent in US history-and while LGBTQ people continue to protest unfair police treatment-little population-level research has examined police contact disparities by sexual orientation or gender identity. We test whether sexual minority (SM) youth have higher risk of police contact through young adulthood. We analyze a nationally representative cohort of >15,000 US young adults who were in middle/high school in the mid-1990s, with police contact histories collected at age 18-25. Using four different, equally reasonable approaches to coding youth-reported sexual orientation, we identified â¼500-1900 SMs. Compared to heterosexual youth, SM youth had 1.86 times the odds of ever being stopped by police (95% CI = 1.56-2.22, p < 0.001), were stopped 1.60 times as often (CI = 1.38-1.86, p < 0.001), and were stopped at younger ages (survival time ratio = 0.91, CI = 0.88-0.93, p < 0.001). Inequities were particularly driven by SM women, among whom disparities were severe (ever stopped OR = 2.18, stop count ratio = 2.44, survival time ratio = 0.87). For men, inequities only emerged once a broad definition of SM was adopted, suggesting that young SM men who do not identify as LGB (or who are reticent to report themselves as such) may be at particular risk. Results were robust to adjustment for race/ethnicity and parental nativity, though small cells meant models stratified by race/ethnicity were underpowered. Given substantially heightened police contact among SM youth (particularly, young SM women), care providers and educators working with them should explicitly combat homophobic and criminal legal system stigma and screen for police contact and its psychological sequelae. More data on LGBTQ communities' criminal legal system contact throughout life is essential for preventing the causes and consequences of related sexual orientation-based health inequities.
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Police contact is a common and consequential experience disproportionately endured by youth of color living in heavily surveilled neighborhoods. Disclosing police contact to others (including parents, siblings, or friends) may buffer against the harmful mental health repercussions of police contact, but little is known about the relationship between disclosure of police contact and mental health. We use data from the Fragile Families and Child Wellbeing Study, a cohort of urban children born around the turn of the 21st century and followed through age 15, to examine the relationship between disclosure of police contact and mental health among youth. Results suggest three conclusions. First, youth who experience police contact (regardless of whether they disclose this contact) report more depressive symptoms and anxiety than youth who do not experience police contact. Second, among youth who experience police contact, disclosure is associated with significantly less anxiety (but is not significantly associated with depressive symptoms). Third, this protective nature of disclosure is concentrated among Black youth and boys. Taken together, these findings suggest that disclosing police contact, particularly for groups most likely to experience it, may ameliorate some of the harmful mental health repercussions of this contact for youth.
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Tuberculosis (TB) primarily affects women during their reproductive years and contributes to maternal mortality and poor pregnancy outcomes. For pregnant women living with HIV (WLHIV), TB is the leading cause of non-obstetric maternal mortality, and pregnant WLHIV with TB are at increased risk of transmitting both TB and HIV to their infants. TB diagnosis among pregnant women, particularly WLHIV, remains challenging, and TB preventive treatment (TPT) coverage among pregnant WLHIV is limited. This project aimed to strengthen integrated TB and reproductive, maternal, neonatal and child health (RMNCH) services in Eswatini to improve screening and treatment for TB disease, TPT uptake and completion among women receiving RMNCH services. The project was conducted from April-December 2017 at four health facilities in Eswatini and introduced enhanced monitoring tools and on-site technical support in RMNCH services. We present data on TB case finding among women, and TPT coverage and completion among eligible WLHIV. A questionnaire (S1 Appendix) measured healthcare provider perspectives on the project after three months of project implementation, including feasibility of scaling-up integrated TB and RMNCH services. A total of 5,724 women (HIV-negative or WLHIV) were screened for active TB disease while attending RMNCH services; 53 (0.9%) were identified with presumptive TB, of whom 37 (70%) were evaluated for TB disease and 6 (0.1% of those screened) were diagnosed with TB. Among 1,950 WLHIV who screened negative for TB, 848 (43%) initiated TPT and 462 (54%) completed. Forty-three healthcare providers completed the questionnaire, and overall were highly supportive of integrated TB and RMNCH services. Integration of TB/HIV services in RMNCH settings was feasible and ensured high TB screening coverage among women of reproductive age, however, symptom screening identified few TB cases, and further studies should explore various screening algorithms and diagnostics that optimize case finding in this population. Interventions should focus on working with healthcare providers and patients to improve TPT initiation and completion rates.
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While individuals returning from prison face many barriers to successful re-entry, among the most serious are the challenges they face in securing housing. Housing has long been recognized as a prerequisite for stable employment, access to social services, and other aspects of individual and family functioning. The formerly incarcerated face several administrative and de facto restrictions on their housing options; however, little is known about the unique instabilities that they face. We use a longitudinal survey of urban families to examine housing insecurity among nearly 3,000 urban men, including over 1,000 with incarceration histories. We find that men recently incarcerated face greater housing insecurity, including both serious hardships such as homelessness, and precursors to homelessness such as residential turnover and relying on others for housing expenses. Their increased risk is tied both to diminished annual earnings and other factors, including, potentially, evictions from public housing supported by Federal "one-strike" policies.
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INTRODUCTION: Women living with HIV are required to transition into the prevention of mother-to-child transmission of HIV (PMTCT) services when they become pregnant and back to ART services after delivery. Transition can be a vulnerable time when many women are lost from HIV care yet there is little guidance on the optimal transition approaches to ensure continuity of care. We reviewed the available evidence on existing approaches to transitioning women into and out of PMTCT, outcomes following transition and factors influencing successful transition. METHODS: We searched PubMed and SCOPUS, as well as abstracts from international HIV-focused meetings, from January 2006 to July 2020. Studies were included that examined three points of transition: pregnant women already on ART into PMTCT (transition 1), pregnant women living with HIV not yet on ART into treatment services (transition 2) and postpartum women from PMTCT into general ART services after delivery (transition 3). Results were grouped and reported as descriptions of transition approach, comparison of outcomes following transition and factors influencing successful transition. RESULTS & DISCUSSION: Out of 1809 abstracts located, 36 studies (39 papers) were included in this review. Three studies included transition 1, 26 transition 2 and 17 transition 3. Approaches to transition were described in 26 studies and could be grouped into the provision of information at the point of transition (n = 8), strengthened communication or linkage of data between services (n = 4), use of transition navigators (n = 12), and combination approaches (n = 4). Few studies were designed to directly assess transition and only nine compared outcomes between transition approaches, with substantial heterogeneity in study design, setting and outcomes. Four themes were identified in 25 studies reporting on factors influencing successful transition: fear, knowledge and preparedness, clinic characteristics and the transition requirements and process. CONCLUSIONS: This review highlights that, despite the need for women to transition into and out of PMTCT services for continued ART in many settings, there is very limited evidence on optimal transition approaches. Ongoing operational research is required to identify sustainable and acceptable transition approaches and service delivery models that support continuity of HIV care during and after pregnancy.
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Fármacos Anti-HIV/uso terapêutico , Infecções por HIV/tratamento farmacológico , Infecções por HIV/prevenção & controle , Transmissão Vertical de Doenças Infecciosas/prevenção & controle , Complicações Infecciosas na Gravidez/tratamento farmacológico , Terapia Antirretroviral de Alta Atividade , Feminino , Infecções por HIV/transmissão , Humanos , GravidezRESUMO
Transitions between services for continued antiretroviral treatment (ART) during and after pregnancy are a commonly overlooked aspect of the HIV care cascade, but ineffective transitions can lead to poor health outcomes for women and their children. In this qualitative study, we conducted interviews with 15 key stakeholders from Ministries of Health along with PEPFAR-supported and other in-country non-governmental organizations actively engaged in national programming for adult HIV care and prevention of mother-to-child-transmission of HIV (PMTCT) services in Côte d'Ivoire, Lesotho and Malawi. We aimed to understand perspectives regarding transitions into and out of PMTCT services for continued ART. Thematic analysis revealed that, although transitions of care are necessary and a potential point of loss from ART care in all three countries, there is a lack of clear guidance on transition approach and no formal way of monitoring transition between services. Several opportunities were identified to monitor and strengthen transitions of care for continued ART along the PMTCT cascade.
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Aleitamento Materno , Adulto , Côte d'Ivoire , Feminino , Humanos , Transferência de Pacientes , GravidezRESUMO
BACKGROUND: Uptake and retention in antenatal care (ANC) is critical for preventing adverse pregnancy outcomes for both mothers and infants. METHODS: We implemented a rapid quality improvement project to improve ANC retention at seven health facilities in Eswatini (October-December 2017). All pregnant women attending ANC visits were eligible to participate in anonymous tablet-based audio assisted computer self-interview (ACASI) surveys. The 24-question survey asked about women's interactions with health facility staff (HFS) (nurses, mentor mothers, receptionists and lab workers) with a three-level symbolic response options (agree/happy, neutral, disagree/sad). Women were asked to self-report HIV status. Survey results were shared with HFS at monthly quality improvement sessions. Chi-square tests were used to assess differences in responses between months one and three, and between HIV-positive and negative women. Routine medical record data were used to compare retention among pregnant women newly enrolled in ANC two periods, January-February 2017 ('pre-period') and January-February 2018 ('post-period') at two of the participating health facilities. Proportions of women retained at 3 and 6 months were compared using Cochran-Mantel-Haenszel and Wilcoxon tests. RESULTS: A total of 1,483 surveys were completed by pregnant women attending ANC, of whom 508 (34.3%) self-reported to be HIV-positive. The only significant change in responses from month one to three was whether nurses listened with agreement increasing from 88.3% to 94.8% (p<0.01). Overall, WLHIV had significantly higher proportions of reported satisfaction with HFS interactions compared to HIV-negative women. A total of 680 pregnant women were included in the retention analysis; 454 (66.8%) HIV-negative and 226 (33.2%) WLHIV. In the pre- and post-periods, 59.4% and 64.6%, respectively, attended at least four ANC visits (p = 0.16). The proportion of women retained at six months increased from 60.9% in the pre-period to 72.7% in the post-period (p = 0.03). For HIV-negative women, pre- and post-period six-month retention significantly increased from 56.6% to 71.6% (p = 0.02); however, the increase in WLHIV retained at six months from 70.7% (pre-period) to 75.0% (post-period) was not statistically significant (p = 0.64). CONCLUSION: The type of rapid quality improvement intervention we implemented may be useful in improving patient-provider relationships although whether it can improve retention remains unclear.
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Satisfação do Paciente/estatística & dados numéricos , Gestantes/psicologia , Cuidado Pré-Natal/estatística & dados numéricos , Retenção nos Cuidados/estatística & dados numéricos , Adulto , Estudos de Coortes , Essuatíni , Feminino , Infecções por HIV/epidemiologia , Humanos , Gravidez , Inquéritos e QuestionáriosRESUMO
Although racial/ethnic disparities in police contact are well documented, less is known about other dimensions of inequity in policing. Sexual minority groups may face disproportionate police contact. We used data from the P18 Cohort Study (Version 2), a study conducted to measure determinants of inequity in STI/HIV risk among young sexual minority men (YSMM) in New York City, to measure across-time trends, racial/ethnic disparities, and correlates of self-reported stop-and-frisk experience over the cohort follow-up (2014-2019). Over the study period, 43% reported stop-and-frisk with higher levels reported among Black (47%) and Hispanic/Latinx (45%) than White (38%) participants. Stop-and-frisk levels declined over follow-up for each racial/ethnic group. The per capita rates among P18 participants calculated based on self-reported stop-and-frisk were much higher than rates calculated based on New York City Police Department official counts. We stratified respondents' ZIP codes of residence into tertiles of per capita stop rates and observed pronounced disparities in Black versus White stop-and-frisk rates, particularly in neighborhoods with low or moderate levels of stop-and-frisk activity. YSMM facing the greatest economic vulnerability and mental disorder symptoms were most likely to report stop-and-frisk. Among White respondents levels of past year stop-and-frisk were markedly higher among those who reported past 30 day marijuana use (41%) versus those reporting no use (17%) while among Black and Hispanic/Latinx respondents stop-and-frisk levels were comparable among those reporting marijuana use (38%) versus those reporting no use (31%). These findings suggest inequity in policing is observed not only among racial/ethnic but also sexual minority groups and that racial/ethnic YSMM, who are at the intersection of multiple minority statuses, face disproportionate risk. Because the most socially vulnerable experience disproportionate stop-and-frisk risk, we need to reach YSMM with community resources to promote health and wellbeing as an alternative to targeting this group with stressful and stigmatizing police exposure.
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Polícia/psicologia , Racismo/psicologia , Comportamento Sexual/psicologia , Minorias Sexuais e de Gênero/psicologia , Adulto , População Negra/psicologia , Cannabis/efeitos adversos , Etnicidade/psicologia , Hispânico ou Latino/psicologia , Humanos , Aplicação da Lei/ética , Masculino , Cidade de Nova Iorque/epidemiologia , População Branca/psicologia , Adulto JovemRESUMO
The mental health impact of exposure to police harassment is understudied, particularly among Black men who have sex with men (BMSM), a group at elevated risk of exposure to such discrimination. This study aimed to identify the associations among BMSM between recent police harassment and psychosocial vulnerability, psychological distress, and depression measured six months later. Data come from the HIV Prevention Trials Network (HPTN) 061 Study, a cohort study of BMSM recruited in 6 U.S. cities (Atlanta, GA, Boston, MA, Los Angeles, CA, New York, NY, San Francisco, CA, and Washington DC). Participants completed baseline, 6-month follow-up, and 12-month follow-up interviews. A convenience sample of 1553 BMSM was recruited between July 2009 and October 2010 of whom 1155 returned for a follow-up interview 12 months later. Accounting for previous police interaction, poverty, psychopathology, drug use, and alcohol use, we estimated associations between recent police harassment reported at the 6 month follow-up interview and 12 month outcomes including psychosocial vulnerability (elevated racial/sexual identity incongruence), psychological distress (being distressed by experiences of racism and/or homophobia), and depression. About 60% of men reported experiencing police harassment between the baseline and 6-month interview due to their race and/or sexuality. Adjusted analyses suggested police harassment was independently associated with a 10.81 (95% CI: 7.97, 13.66) point increase and 8.68 (95% CI: 6.06, 11.30) point increase in distress due to experienced racism and distress due to experienced homophobia scores, respectively. Police harassment perceived to be dually motivated predicted disproportionate levels of distress. Police harassment is prevalent and associated with negative influences on psychosocial vulnerability and psychological distress among BMSM. Reducing exposure to police harassment may improve the psychosocial health of BMSM.
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RATIONALE: Effective human immunodeficiency virus (HIV) prevention requires a coordinated continuum of services to foster early diagnosis and treatment. Early linkage to care (LTC) is critical, yet programmes differ in strategies to monitor LTC. METHODS: In 2014, we visited 23 HIV testing and care service delivery points in Mozambique to assess programme strategies for monitoring LTC. We interviewed key informants, reviewed forms, and matched records across service points to identify successful models and challenges. RESULTS: Forms most useful for tracking LTC included individual identifiers, eg, patient name, unique identifier (ie, National Health Identification Number [NID]), sex, and date of birth. The majority (67%) of records matched occurred in the presence of a unique NID. Key informants described challenges related to processes, staffing, and communication between service delivery points to confirm LTC. CONCLUSIONS: While tracking clients from HIV testing to care is possible, programmes with insufficient tracking procedures are likely to underreport LTC. Adoption of additional patient identifiers in testing registers and standardized protocols may improve LTC programme monitoring and reduce underreporting.
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Infecções por HIV , Teste de HIV , Atenção à Saúde , Diagnóstico Precoce , Infecções por HIV/diagnóstico , Infecções por HIV/epidemiologia , Humanos , Moçambique/epidemiologiaRESUMO
BACKGROUND AND AIMS: While substance use can lead to incarceration, the disruptive effects of incarceration may lead to, or increase psychosocial vulnerability and substance use. Using causal inference methods, we measured longitudinal associations between incarceration and post-release substance use among Black men who have sex with men (BMSM), populations facing disproportionate risk of incarceration and substance use. METHODS: Using data from the HIV Prevention Trials Network (HPTN 061) study (N = 1553) we estimated associations between past 6-month incarceration and binge drinking, marijuana use, and stimulant use post release (at 12-month follow-up visit). Adjusted models used inverse probability weighting (IPW) to control for baseline (pre-incarceration) substance use and additional risk factors. RESULTS: There were 1133 participants present at the twelve-month follow-up visit. Participants were predominately non-Hispanic Blacks and unemployed. At baseline, 60.1 % reported a lifetime history of incarceration, 22.9 % were HIV positive and 13.7 % had a history of an STI infection. A total of 43 % reported a history of depression. In adjusted analyses with IPW, recent incarceration was associated with crack-cocaine (adjusted odds ratio (AOR): 1.53, 95 % confidence interval (CI): 1.03, 2.23) and methamphetamine use (AOR: 1.52, 95 % CI: 0.94-2.45). Controlling for pre-incarceration binge drinking, incarceration was associated with post-release binge drinking (AOR: 1.47, 95 % CI: 1.05, 2.04); in fully adjusted models the AOR was 1.14 (95 % CI: 0.81, 1.62). Incarceration was not associated with marijuana use. CONCLUSION: Findings underscore the need to provide substance use treatment in custody and post-release, and to consider alternatives to incarceration for substance using populations.
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Contemporary American policing has routinized involuntary police contacts with young people through frequent, sometimes intrusive investigative stops. Personal experience with the police has the potential to corrode adolescents' relationships with law and skew law-related behaviors. We use the Fragile Families and Child Wellbeing Study to estimate how adolescents' experiences with the police shape their legal socialization. We find that both personal and vicarious police contact are associated with increased legal cynicism. Associations are present across racial groups and are not explained by teens' behaviors, school settings, or family backgrounds. Legal cynicism is amplified in teens reporting intrusive contact but diminished among teens reporting experiences characterized by procedural justice. Our findings suggest that aggressive policing risks weakening teens' deference to law and legal authorities.
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This research evaluates whether personal and vicarious police contact are related to self and caregiver-reports of teen health and to what extent these associations vary by perceptions of procedural injustice. We analyzed longitudinal health data collected from adolescents in the Fragile Families and Child Wellbeing Study (Nâ¯=â¯3435), alongside teen self-reports of whether they were stopped by the police or experienced vicarious police contact, and if so, their perceptions of procedural injustice in these encounters. We estimated regression models with lagged dependent variables and a propensity score weighting approach. Our analysis yielded four important results. First, participants who reported personal or vicarious police stops had worse self-reported health in adolescence than their counterparts with no contact. Second, both types of police contact were unrelated to caregiver reports of adolescent health and inconsistently related to somatic symptoms. Third, procedural injustice exacerbated the relationship between both personal and vicarious contact and diminished self-reported health. Finally, the associations between police contact and self-reported health were stronger among black and Hispanic adolescents than white ones. Our results highlight personal and vicarious police contact, particularly instances viewed as procedurally unjust, as commonly experienced adverse health events among urban adolescents.