Date on Master's Thesis/Doctoral Dissertation

5-2024

Document Type

Doctoral Dissertation

Degree Name

Ph. D.

Department

Health Promotion and Behavioral Sciences

Degree Program

Public Health Sciences with a specialization in Health Promotion, PhD

Committee Chair

Kerr, Jelani

Committee Member

Kelly-Pryor, Brandy

Committee Member

Sterrett-Hong, Emma

Committee Member

Hall-Byers, Naomi

Author's Keywords

HIV; mass incarceration; masculinity; health equity; black health

Abstract

In 2018, Black Americans represented 42% of new HIV diagnoses, despite comprising only 13% of the population. Moreover, Black men accounted for three-quarters of new HIV cases in 2016, with Black gay/bisexual men contributing to the majority of incidence among Black Americans. Existing literature suggests that individual behavior alone cannot explain these racial inequities in HIV rates. This study aims to explore the role of the criminal legal system (CLS) as a structural determinant of health, given its historical racial implications that disproportionately affect Black Americans. Additionally, the study examines masculinity’s influence as a predictor of risky sexual behavior. This study addressed the gap in understanding how the CLS impacts masculinity and HIV vulnerability among formerly incarcerated Black men who have sex with men and women, while also investigating the role of prosocial masculinity within this population. Utilizing a sequential explanatory study design, a secondary analysis (bivariate and multivariate models; n=239) and semi structured interviews (n=9) were conducted. Findings indicate that incarceration may influence risky sexual behaviors through masculinity, with different types of masculinity affecting HIV vulnerability positively and negatively. Findings indicate that incarceration may influence risky sexual behaviors through masculinity, with different types of masculinity affecting HIV vulnerability positively and negatively. Participants suggested enhancing health education and promotion efforts in correctional facilities that include novel HIV prevention approaches. Furthermore, this study carries implications for policy, including the consideration of repealing HIV criminalization laws and implementing second chance policies for formerly incarcerated individuals. Future research should further investigate the interplay between masculinity and sexual risk behaviors, as well as devising methods to foster prosocial masculinity and overcome reintegration obstacles hindering its adoption.

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