HIV Risk Reduction for Women with Incarcerated Partners

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DESCRIPTION (provided by applicant): Women with incarcerated male partners are at increased risk for HIV; their vulnerability is conferred by the specific context of their partner?s incarceration. Incarcerated men are over five times more likely than men in the general population to be infected with HIV (Bureau of Justice Statistics, 1999). Some are exposed to HIV before incarceration; others are exposed during incarceration from sharing needles or having unprotected sex in prison where condoms and sterile needles are not available. When incarcerated men return home and have unprotected sex or share needles with their partners, their partners are at risk for infection. This is a major public health issue as there are currently over 2 million people incarcerated in the U.S. (over 90 percent males), up to 14 million people pass through the criminal justice system each year, and most inmates are released after a short stay in prison or jail. Although women with incarcerated partners are at increased risk for HIV, there have been no intervention studies specifically targeting HIV risk reduction for this vulnerable population. In this study, we will: (1) Conduct multi-method formative research to refine a population-specific theoretical model of HIV risk and risk reduction for women with incarcerated male partners that includes individual (misinformation, risk denial and minimization, isolation), couple (relationship pressures), and contextual (institutional policies) factors; (2) Develop a population-specific HIV risk reduction intervention for women with incarcerated partners based on the revised theoretical model; (3) Examine the feasibility, acceptability and effectiveness of the intervention in addressing the risk domains of the model (e.g. increasing accurate information, social support and communication skills) and in reducing unprotected intercourse and needle sharing when partners are released from prison. In the formative phase of the study, we will conduct qualitative interviews with 20 women visiting their incarcerated partners and 15 service providers, and quantitative surveys with 220 women both before and after their partners are released from prison to test a population-specific HIV risk model. Intervention and instrument development will use formative research findings and the input of a Community Advisory Board (CAB). We will use qualitative and quantitative methods to examine the feasibility and acceptability of the intervention, and a preliminary test of intervention effectiveness will be accomplished by comparing the 125 intervention participants with a comparison sample that will be recruited and assessed before the intervention cohort.