Background: This longitudinal study assessed associations between criminal justice involvement (CJI) and sexual risk behaviors in a sample of male migrant and non-migrant vendors in the largest open-air marketplace in Central Asia. We hypothesized that questioning by market officials and migration police, experiencing arrest and incarceration would be associated with greater likelihood of sex under the influence of drugs or alcohol, more than one sexual partner, condomless sex, transactional sex, condomless sex while traveling, and more than one sexual partner while traveling.
Methods: We employed respondent driven sampling (RDS) to recruit 1,342 male vendors consisting of external migrants from Tajikistan, Uzbekistan, and Kyrgyzstan, internal migrants and a non-migrant comparison group from Kazakhstan. Multiple imputation with chained equations (ICE) adjusted for bias introduced from missing data at baseline and 3, 6, and 12-month assessments (5,863 observations). Multi-level logistic regression with time period fixed effects and random intercepts estimated odds ratios (OR) of associations between CJI and sexual risk behaviors overall and by non-migrant and migrant groups.
Results: Table 1 provides CJI, and sexual risk behaviors stratified by migration status. In multivariate models, questioning by market officials predicted increased risk of condomless sex (OR=1.02, SE=.01, p< .05), sex under the influence of drugs/alcohol (OR=1.03, SE=.01, p< .01), transactional sex (OR=1.05, SE=.01, p< .001) and more than one sexual partner while traveling (OR=1.06, SE=.02, p< .001). Contacts with migration police predicted increased risk of sex under the influence of drugs/alcohol (OR=1.02, SE=.008, p< .01). Arrest predicted increased risk of sex under the influence of drugs/alcohol (OR=1.91, SE=.31, p< .001), more than one sexual partner (OR=1.33, SE=.20, p< .10), condomless sex (OR=1.42, SE=.16, p< .01), transactional sex (OR=1.96, SE=.44, p< .01) and more than one sexual partner while traveling (OR=2.62, SE=.60, p< .001). Incarceration predicted increased risk of sex under the influence of drugs (OR=3.79, SE=1.08, p< .001), sex with more than one partner (OR=1.71, SE=.44, p< .05) and transactional sex (OR=4.16, SE=1.70, p< .001).

 External migrant %(obs.)Internal migrant %(obs.)Non-migrant %(obs.)Overall %(obs.)
Sex under the influence of drugs/alcohol11.47(143)15.08(141)11.60(219)12.49(503)
Transactional sex7.31(72)6.76(66)5.99(101)6.47(239)
Unprotected sex35.53(609)32.54(321)34.66(585)34.28(1515)
>1 sex partner while traveling3.16(31)7.37(55)4.24(59)4.84(145)
Questioning by market officials1.05(.21).50(.11).51(.11).62(.08)
Questioning by migration police3.10(.50).86(.27)1.13(.28)1.47(.18)
[Table 1. Population estimates of CJI and sexual risk by migration status (obs. 5868)]

Conclusions: Findings underscore the need for structural interventions that target law enforcement and other criminal justice policies to facilitate HIV prevention interventions with key populations including male labor migrant market vendors in Kazakhstan.