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Objectives: This paper describes research that examined the association between high‐risk sexual and drug‐using behaviors during incarceration and HIV infection for African‐American men receiving HIV care at three public medical centers in Los Angeles County (LAC), California. Methods: A case‐control study was conducted in which 305 HIV‐infected African‐American men and 305 neighborhood controls, ages 20 to 49, were frequency‐matched by age. Results: After controlling for anal sex while not incarcerated, we found no association between anal sex during incarceration and HIV (odds ratio [OR], 1.1; 95% confidence interval [CI], 0.6‐2.2). Among men with a history of incarceration (n = 332), the percentage reporting anal sex with men outside of incarceration (45%) was greater than those reporting anal sex while incarcerated (16%). Injection drug use (IDU) during incarceration was also not associated with HIV when controlling for IDU outside of incarceration (OR, 1.6; 95% CI, 0.5‐ 4.9). Increased time in jail or prison was associated with less HIV infection (p = .001). Conclusions: Although high‐risk behaviors are more common in the community than in the incarcerated setting for this study group, incarcerated populations represent a high‐risk group for whom access to prevention messages is limited. Periods of incarceration represent a unique opportunity to convey prevention messages that focus on high‐risk behaviors outside the incarcerated setting.

High-Risk Behaviors During Incarceration in African-American Men Treated for HIV at Three Los Angeles Public Medical Centers