HIV Risk Reduction for Women with Incarcerated Partners

描述(由申请人提供)：有被监禁的男性伴侣的妇女感染艾滋病毒的风险增加；她们的脆弱性是由其伴侣的特定背景--S被监禁--赋予的。被监禁男子感染艾滋病毒的可能性是一般人口男子的五倍以上(司法部统计局，1999年)。一些人在入狱前接触到艾滋病毒；另一些人在入狱期间因共用针头或 在监狱里无保护措施的性行为，那里没有避孕套和无菌针头。当被监禁的男性回到家，进行无保护措施的性行为或与伴侣共用针头时，他们的伴侣面临感染的风险。这是一个重大的公共卫生问题，因为目前美国有200多万人被监禁(90%以上是男性)，每年有多达1400万人通过刑事司法系统，大多数囚犯在短期内获释 要么呆在监狱里，要么坐牢。尽管有被监禁伴侣的妇女感染艾滋病毒的风险增加，但还没有专门针对这一弱势群体降低艾滋病毒风险的干预研究。 在这项研究中，我们将：(1)进行多方法形成性研究，以完善特定人群的艾滋病毒风险和减少风险的理论模型，其中包括个人(错误信息、风险否认和最小化、隔离)、夫妇(关系压力)和背景(制度政策)因素；(2)制定特定人群的理论模型 根据修订的理论模型，对有被监禁伴侣的妇女采取减少艾滋病毒风险的干预措施；(3)审查干预措施的可行性、可接受性和有效性，以解决该模式的风险领域(例如，增加准确的信息、社会支持和沟通技能)，并减少伴侣出狱时无保护措施的性行为和共用针头。 在研究的形成阶段，我们将对20名探望被监禁伴侣的女性和15名服务提供者进行定性访谈，并对220名女性在她们的伴侣出狱前后进行定量调查，以测试特定人群的艾滋病毒风险模型。干预和工具开发将使用形成性研究结果和社区咨询委员会(CAB)的投入。我们将使用 将采用定性和定量方法检查干预的可行性和可接受性，并通过将125名干预参与者与将在干预队列之前招募和评估的对照样本进行比较来完成干预效果的初步测试。

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.