How Incarceration Impacts HIV Risk Among Black Sexual Minority Men

August 10, 2020

A study by Ph.D. student Joseph Carter (Psychology) and fellow researchers unearths the connections between incarceration, police discrimination, and HIV risk and outcomes for Black sexual minority men.

Credit: Getty Images
Credit: Getty Images

LGBTQI+ people are three times as likely to be incarcerated as the general public, enduring longer sentences, sexual abuse, and inadequate access to health care behind bars. Black men are six times as likely to be incarcerated than white men. And when these identities intersect, the consequences are even more dire. 

Though these devastating statistics are well known, a new study looks at the impacts of criminalization on an especially vulnerable group within the Black community: Black sexual minority men. In “Intersectional social control,” published in Social Science & Medicine, Graduate Center Ph.D. student Joseph Carter (Psychology) and fellow researchers unearth the connections between incarceration, police discrimination, and HIV risk and outcomes. 


Student photo Joseph-Carter-469

“We wanted to do more with the idea of incarceration and police discrimination at both the structural and individual levels. It’s something that hasn’t gotten a lot of attention in the research world, particularly within the context of public health,” Carter says of himself and his fellow researchers. “We had this giant data set of thousands of sexual minority men. We wanted to look at HIV-related outcomes and some of the psychological health outcomes as well.” 

The researchers utilized a data set of over 1,000 Black sexual minority men and determined that incarceration and criminalization put this population at increased risk of HIV, affects their willingness to use PrEP (pre-exposure prophylaxis), and is associated with psychological distress. Thus, the authors described mass incarceration as a “public health emergency” for Black sexual minority men."

“The large, overarching implication of the study is that, when we’re looking at incarceration and police discrimination, we must look at it through a lens of intersectionality,” Carter explains. “If we just look at Black men in general, we’d miss some of these associations — the association of police discrimination and psychological distress and the association between incarceration and HIV-related outcomes. In our sample, these associations are unique to Black sexual health minority men.”

Carter, a queer Black man, says he has attended several protests in recent months and notes that the resurgence of the Black Lives Matter movement has shed sustained light on “how out of control the carceral state has been, specifically toward the Black community.” 

Still, he notes, lasting progress will require structural change.

“The reality of the situation is that the most effective intervention we have on this is a massive structural reform of the carceral state. That includes completely overhauling our carceral system, if we should even incarcerating people at all,” Carter says. “There may be public health interventions that can reduce the after-effects of incarceration. There are community-level interventions that do this. But in terms of the most efficacious interventions, it really does take this larger structural dismantling of the carceral state.”