Incarceration Effects on Prevention of Drug Use, STI-HIV and Recidivism

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DESCRIPTION (provided by applicant): The proposed training and research is to examine the public health impact of incarceration on female inmates' return to the community from a large urban jail. The training plan will provide interdisciplinary mentorship for the candidate in refining theoretical knowledge and research skills required for subsequent prevention research. The proposed study will examine relapse to drug use, STIs/HIV risks, and recidivism over time, by exploring related individual and community factors which may be unique to female inmates. While a large proportion of current incarcerations is drug related, these drug offenders often come from disadvantaged neighborhoods. Our goal is to better understand the impact of incarceration on the health of female inmates and their communities so that we may then develop gender specific interventions for successful reentry into those communities. To achieve this goal, we propose the following: 1) to conduct qualitative in-depth interviews to explore women's experiences with incarceration, health concerns, and service needs upon release. The findings will be used in designing the following survey questionnaire. 2) Conduct survey interviews with a cohort of 400 female inmates at baseline in jail, two weeks and three months post-release. 3) Establish community variables including community disadvantage, residential stability, concentrated incarceration and STIs, using booking, laboratory, and the US 2000 census data. These community variables will be matched with the survey data for the following analysis. 4) Test the effectiveness of the proposed conceptual model in explaining the impact of incarceration on female inmates returning to the community and revise accordingly. Multi-level and spatial analyses will be performed to examine the effects of community and individual factors on female inmates' primary outcomes: relapse to drugs, risks of STIs/HIV, recidivism and secondary outcomes: homelessness, employment, access to services, reunification with children, and psychosocial distress. The associations between community and individual factors and women's social network and social support measures will be examined. The effects of social network and social support on these outcomes will also be examined. Health problems among inmates are public health concerns, as the majority of inmates return to the community after a short stay in jail. Improving the health of this population-at-risk will help protect the health and well-being of the public.