Assessing the relationship between parental imprisonment in childhood and risk of sexually transmitted infections: a cohort study of US adults in early adulthood

OBJECTIVES: One in six young adults in the USA experiences parental imprisonment in childhood. Prior studies have associated parental imprisonment with risk of sexually transmitted infection (STI); however, potential data and methodological issues may have limited the reliability and accuracy of prior findings. Examining cumulative and longitudinal risk, we address several methodological limitations of prior studies and also examine comparative risk by respondent sex and ethnicity. We assess these associations using a range of control variables. DESIGN: A national cohort study from the National Longitudinal Study of Adolescent to Adult Health using (1) a cross-sectional sample of adults at ages 24–32 years and (2) a longitudinal sample between ages 18 and 32 years. Both analyses estimate ORs for STI associated with parental imprisonment and examine variation by parent/child gender and respondent ethnicity. SETTING: In-home interviews in the USA at wave 1 (1994–1995), wave 3 (2001–2003) and wave 4 (2007–2009). PARTICIPANTS: 15 684 respondents completing interviews at wave 1 (ages 12–18 years) and wave 4 (ages 26–32 years), including 8556 women, 3437 black and 2397 respondents reporting parental imprisonment. RESULTS: Father-only imprisonment is associated with 1.22 higher odds (95% CI: 1.09 to 1.37) of lifetime STI and 1.19 higher odds (95% CI: 1.01 to 1.41) of STI in the past 12 months between ages 18 and 32 years, adjusting for familial, neighbourhood, individual and sexual risk factors. Maternal imprisonment is not associated with higher risk of lifetime STI after adjusting for confounders (95% CI: 0.90 to 1.61). Examining predicted probabilities of STI, our findings show additive risks for women, black people and parental imprisonment. CONCLUSION: Adjusting for confounders, only paternal imprisonment is associated with slightly elevated risk of annual and lifetime risk of STI. Additive effects show that parental imprisonment modestly increases ethnic and female risk for STI.