Bringing it home: design and implementation of an HIV/STD intervention for women visiting incarcerated men.
ABSTRACT Incarceration has been identified as a key variable to be addressed in halting the HIV epidemic among African Americans. Our research team has been conducting and evaluating HIV prevention interventions for prisoners and their families since the early 1990s, including interventions specifically tailored to the needs of women with incarcerated partners. This article describes the development and implementation of a multicomponent HIV prevention intervention for women with incarcerated partners, and presents qualitative data from women who participated as peer educators in this intervention. Women with incarcerated partners reported low rates of condom use and HIV testing combined with a lack of information about prison-related HIV risks. We found that peer education is a feasible intervention to reach women with incarcerated partners and that flexibility and inclusiveness are important factors in designing intervention programs for this population.
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ABSTRACT: The massively disproportionate impact of America's prison boom on communities of color has raised questions about how incarceration may affect health disparities, including disparities in HIV. Primary partners are an important source of influence on sexual health. In this paper, we investigate sexual HIV risk among male-female couples following a man's release from prison. We draw upon data from the Relate Project, a novel cross-sectional survey of recently released men and their female partners in Oakland and San Francisco, California (N=344). Inferential analyses use the actor-partner model to explore actor and partner effects on sexual HIV risk outcomes. Dyadic analyses of sexual HIV risk among male parolees and their female partners paint a complex portrait of couples affected by incarceration and of partners' influences on each other. Findings indicate that demographic factors such as education level and employment status, individual psycho-social factors such as perception of risk, and relationship factors such as commitment and power affect sexual HIV risk outcomes. The Relate Project provides a novel dataset for the dyadic analysis of sexual risk among male parolees and their female partners, and results highlight the importance of focusing on the couple as a unit when assessing HIV risk and protective behaviors. Results also indicate potentially fruitful avenues for population-specific interventions that may help to reduce sexual health disparities among couples affected by incarceration.
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ABSTRACT: Background & Purpose Women are one of the fastest growing segments of the U.S. criminal justice system. Female offenders have HIV rates that are three to fifteen times that of the general population of women. In correctional settings, HIV prevalence is also significantly higher for women than men, even after controlling for race and ethnicity. Only in recent years has HIV prevention science begun to build an evidence base in targeting criminal justice-involved women. What is currently lacking is evidence of the relative efficacy of HIV prevention interventions for women with criminal justice involvement. We also do not thoroughly understand the effect of an intervention’s setting within the criminal justice landscape or its theoretical orientation on reducing HIV risk. Toward this end, we conducted a systematic review and meta-analysis of HIV prevention interventions for women with criminal justice involvement. Methods We conducted a systematic review of the literature published from 1980 until April 2013 on HIV prevention interventions for women with criminal justice involvement, using 26 search terms in 13 online article databases. Inclusion criteria for studies consisted of: 1) criminal justice involvement of participants, 2) an exclusively female sample or gender-specific outcomes, 3) presence of a control/comparison group, and 4) at least one quantitative behavioral HIV risk outcome. Articles were coded on multiple study factors, including setting, theoretical orientation, race/ethnicity, and juvenile/adult sample composition. We calculated the standardized mean difference (SMD) or Cohen’s d for each intervention by dividing the mean difference by the pooled standardized deviation of the two groups. Effect sizes for the studies, based on the SMD were estimated using a random effects model, using the statistical software, Comprehensive Meta-analysis. Particular attention was paid to intervention setting and specific theoretical basis, if any. Results A total of eighteen journal articles were found that addressed HIV interventions targeting women with criminal justice involvement. Six articles were eliminated either because the same intervention was reviewed in multiple articles or because the study did not have a control/comparison group, leaving a final sample of twelve and a total nof 3,087. Nine studies were randomized control trials, and three had quasi-experimental designs. While ten interventions were delivered in prison or jail settings, only two were delivered in the community. The effect size for reduction in sexual risk behavior outcomes (i.e. number of unprotected sexual occasions) was -0.239 [-0.386, -0.091; SE=0.087, p=0.002]. Forest plots were created to illustrate the range of effect size across interventions. Conclusions & Implications Extant HIV prevention interventions are moderately efficacious at addressing the reduction of HIV sexual risk for women offenders, although there is need for further intervention development and implementation across the criminal justice spectrum. Given the results of this systematic review, this development should emphasize the use of cognitive-behavioral and social cognitive approaches to maximize the potential impact of HIV prevention interventions for this vulnerable population.The Society for Social Work and Research 2014 Annual Conference; 01/2014
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ABSTRACT: Having an incarcerated partner presents a unique HIV risk for women, particularly low-income women of color. We developed a population-specific risk reduction intervention for women visiting men in prison that was peer educator-based and included individual and community-level intervention components. Women who were assessed prior to the intervention period had a positive association between the number of unprotected penetrative intercourse (UPI) episodes prior to their partners' incarceration and the number of UPI episodes following partners' release from prison. However, this association was negated among women assessed during the intervention. Intervention participants also were more likely to be tested for HIV, to have partners who got tested, and to talk with their partners about significantly more HIV-related topics. Conducting intervention and evaluation activities with women visiting incarcerated men is feasible and is a useful model for reaching more at-risk women.AIDS and Behavior 02/2011; 15(2):365-75. DOI:10.1007/s10461-010-9770-4 · 3.49 Impact Factor