Emotion and Relationships Underlying HIV/HCV Risk Among Incarcerated Women

尽管被监禁妇女对艾滋病毒和丙型肝炎的易感性不成比例，但她们很少成为预防研究的重点。在社区中很难接触到有风险的妇女；因此，监狱为接触妇女提供了一个独特的机会，因为她们有时间参与预防规划，而不是全神贯注于其他紧迫的需要(例如，儿童保育、住所、下一顿饭、获得毒品)。由于监狱中的绝大多数女性很快就会回到她们的社区(特拉维斯，2005年)，她们的高感染率也对公共卫生产生了严重的影响。最近对艾滋病毒预防干预措施的荟萃分析表明，必须调整目前的危险行为模式，以有效地适应不同人群的需求。由于对被监禁妇女进行的研究很少，因此需要进行形成性研究，以确定哪些因素对她们的危险行为影响最大，以便通过干预来针对这些因素。这项拟议的研究涉及一项基于社会行动理论(SAT)的混合方法研究，以评估被监禁妇女的危险行为模式。在经典社会认知理论的基础上，SAT强调了两个主要组成部分：(1)动态的健康行为状态；(2)自我改变的过程；并纳入了人际动态和内部情感状态等语境因素。在目前的研究中，将使用对被监禁妇女(N=20)的定性深入访谈来检查动态的健康行动状态，其中包括与性伴侣的相互依赖和所采取行动的经历后果。在对被监禁妇女(N=200)的结构化调查中收集的定量数据将被用来测试自我改变过程，特别是寻找纳入风险行为的既定认知预测因素的影响的途径，以及亲密关系控制和心理痛苦对性风险承担的影响。这项研究将是一项研究计划的第一步，最终将导致设计一种综合干预措施，将心理健康治疗和风险预防结合在一起，在惩教环境中实施。申请者是全国第一临床心理学项目的尖子生，已经获得了监狱和国务院管理人员的支持。她还组建了一个专家小组，为申请者制定了全面的培训计划，并渴望帮助实现奖学金目标。

Despite their disproportionate vulnerability to HIV and Hepatitis C (HCV), incarcerated women are rarely the focus of prevention research. At risk women can be difficult to reach in the community; so prison provides a unique opportunity to gain access to women while they have the time available to engage in prevention programming and are not preoccupied by other immediate needs (e.g. childcare, shelter, next meal, drug acquisition). Since the vast majority of women in prison will soon return to their communities (Travis, 2005), their elevated infection rates also carry serious public health implications. Recent meta-analyses of interventions in HIV prevention have demonstrated that current risk behavior models must be adapted to effectively fit the needs of distinct populations. Since very little research has been conducted with incarcerated women, formative research is needed to establish which factors are most influential in their risk behavior so that these factors can be targeted through interventions. The proposed research involves a mixed-methods study to evaluate a model of risk behavior among incarcerated women based on Social Action Theory (SAT). Expanding upon classic social-cognitive theories, SAT emphasizes two major components: (1) the dynamic health action state; and (2) the self-change process; and incorporates contextual factors like interpersonal dynamics and internal affective states. In the current study, qualitative in-depth interviews with incarcerated women (N = 20) will be used to examine the dynamic health action state, which includes interdependence with a sexual partner and experienced consequences of action taken. Quantitative data collected in structured surveys with incarcerated women (N = 200) will be used to test the self-change process, specifically looking at pathways that incorporate the impact of established cognitive predictors of risk behavior, as well as intimate relationship control and psychological distress, on sexual risk-taking. This study will be the first step in a program of research ultimately leading to the design of a comprehensive intervention that integrates mental health treatment and risk prevention to be administered within correctional settings. The applicant, a top student at the #1 clinical psychology program in the country, has already obtained the support of prison and state department administrators. She has also assembled a team of experts who have devised a comprehensive training plan for the applicant, and are eager to assist in achieving the fellowship goals.