Relationship Disruption during Incarceration and HIV Risk in African American Men

非裔美国男性监禁期间关系破裂和艾滋病毒风险

• 批准号: 8536782
• 负责人: Maria Rabia Khan
• 金额: $ 61.35万
• 依托单位: UNIVERSITY OF FLORIDA
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-08-01 至 2014-09-14
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8536782
• 关键词: AIDS prevention; Accounting; Address; Affect; African American; Alcohols; Anxiety; Automobile Driving; Characteristics; Chlamydia; Cohort Studies; Commit; Communication; Communities; Crime; Criminal Justice; Data; Distress; Drug usage; Economics; Emotional; Enrollment; Epidemic; Face; Feedback; Fostering; Frequencies; Gap Junctions; General Population; Gonorrhea; HIV; HIV risk; Health; Heterosexuals; Home environment; Imprisonment; Incidence; Infection; Intervention; Interview; Lead; Life; Link; Literature; Measurement; Measures; Mediating; Mental Depression; Mental Health; Methods; North Carolina; Outcome; Participant; Pathway interactions; Pattern; Perception; Persons; Pharmaceutical Preparations; Pilot Projects; Policies; Population; Prevention education; Preventive Intervention; Prisons; Privacy; Process; Prospective Studies; Psyche structure; Public Health; Qualitative Research; Race; Recording of previous events; Recruitment Activity; Research; Research Infrastructure; Respondent; Risk Behaviors; Risk Factors; Schedule; Science; Self Medication; Sexual Partners; Social Environment; Social support; Structure; Surveys; Testing; Time; Trichomonas Infections; Unsafe Sex; Work; base; binge drinking; burden of illness; coping; design; development policy; experience; injection drug use; insight; intimate behavior; male; meetings; member; men; offender; prevent; programs; public health relevance; response; sex; sex risk; sexually active; social; social integration; transmission process

DESCRIPTION (provided by applicant): African American men released from prison face disproportionate HIV risk. Preventing HIV sexual risk behavior and drug use in this group is critical to reducing the race disparity in HIV. However, research on the factors that drive and protect against HIV risk among African American male releasees is limited. Returning to a committed partner after release may be an important protective factor against HIV risk among African American male releasees during reentry. However, incarceration destabilizes committed relationships. Though 50-80% of men enter prison in a committed relationship, we estimate that half of these relationships end by the time of release. Upon release, loss of a partner may lead men to seek multiple, new partners to meet companionship needs or may lead to distress and, in turn, self-medication with drugs or sex. No prior study has evaluated the degree to which partner loss during incarceration influences post-release HIV risk. The present mixed method study is designed to address this gap in the current field of HIV prevention science. This study seeks to examine the hypothesis that dissolution of stable intimate relationships during incarceration elevates sexual risk behavior and drug use among inmates upon their release. The specific aims are: Primary Quantitative Aims: Aim 1. Among African American men in relationships at the time of prison entry, to describe the associations between dissolution of relationships during incarceration and HIV sexual risk behavior (unprotected sex; multiple sex partnerships; buying sex for money or drugs) and drug use (crack use; binge drinking). Aim 2. To assess whether diminished mental health (low coping; increased depression; increased anxiety) due to dissolution of relationships during incarceration results in HIV sexual risk behavior and drug use. Aim 3. To evaluate whether the association between dissolution of relationships during incarceration and HIV sexual risk behavior and drug use varies by respondent and relationship characteristics. Qualitative Aim: To qualitatively explore the social context of post-release and men's perceptions of the factors and processes driving post-release sexual risk behavior and drug use. To accomplish these study aims, we propose to recruit 400 African American male inmates who are scheduled to be released from prison and who were in stable intimate heterosexual relationships at the time of prison entry. Our pilot work suggests that ~50% of relationships will have ended during the incarceration. We will follow men after their release to assess whether post-release sexual risk behavior and drug use are higher among men whose relationships ended during incarceration versus men whose relationships remained intact. The proposed study is designed to inform development of policies and interventions that minimize the destabilizing effects of criminal justice involvement on relationships and health. PUBLIC HEALTH RELEVANCE: Since more than 800,000 African American men are incarcerated in prison at any given time, and hundreds of thousands return home to their communities each year, policies and programs that are effective in reducing HIV risk in this group would prevent substantial numbers of new infections among African American men and members of their sexual networks annually. This research will determine whether dissolution of committed relationships during incarceration is a risk factor for post-release HIV sexual risk behavior and drug use among African American male releasees and will describe the pathways through which relationship dissolution may work to influence HIV risk. Study findings may highlight the need for implementation of criminal justice policies that reduce network disruption and may inform HIV prevention interventions, including in-prison programs for inmates and their partners that foster communication and prevent relationship dissolution, and pre-release HIV prevention education for men who have lost a committed partner during incarceration.

描述（由申请人提供）：从监狱释放的非洲裔美国人面临不成比例的艾滋病毒风险。在这一群体中预防艾滋病毒性风险行为和药物使用对于减少艾滋病毒的种族差异至关重要。然而，对非洲裔美国男性释放者中驱动和保护艾滋病毒风险的因素的研究是有限的。释放后回到一个承诺的合作伙伴可能是一个重要的保护因素，对艾滋病毒的风险之间的非洲裔美国男性释放人员在重返社会。然而，监禁破坏了承诺的关系。虽然50-80%的男性在一段忠诚的关系中进入监狱，但我们估计这些关系中有一半在释放时结束。一旦释放，失去伴侣可能会导致男性寻求多个新的伴侣来满足陪伴的需要，或者可能导致痛苦，进而通过药物或性自我治疗。没有先前的研究评估在监禁期间失去伴侣对释放后艾滋病毒风险的影响程度。本混合方法研究旨在解决当前艾滋病毒预防科学领域的这一差距。本研究旨在检验这一假设，即在监禁期间，稳定的亲密关系的解体会提高囚犯释放后的性风险行为和药物使用。具体目标是：主要量化目标：目标1。在进入监狱时处于关系中的非洲裔美国男性中，描述监禁期间关系的解除与艾滋病毒性风险行为（无保护措施的性行为;多个性伴侣;为金钱或毒品购买性行为）和药物使用（使用快克;酗酒）之间的关联。目标二。评估由于监禁期间关系的解除导致的心理健康下降（低应对;抑郁增加;焦虑增加）是否会导致HIV性风险行为和药物使用。目标3。评估监禁期间关系的解除与HIV性风险行为和药物使用之间的关联是否因受访者和关系特征而异。定性目标：定性探讨释放后的社会背景和男性对释放后性风险行为和药物使用的因素和过程的看法。为了实现这些研究目标，我们建议招募400名非洲裔美国男性囚犯，他们计划从监狱中释放，并在进入监狱时处于稳定的亲密异性关系中。我们的试点工作表明，约50%的关系将在监禁期间结束。我们将在释放后跟踪男性，以评估在监禁期间结束关系的男性与关系保持完整的男性之间释放后的性风险行为和药物使用是否更高。拟议的研究旨在为制定政策和干预措施提供信息，以最大限度地减少刑事司法介入对关系和健康的破坏性影响。 公共卫生相关性：由于在任何时候都有超过80万非洲裔美国人被监禁在监狱中，每年有数十万人返回家园，因此有效降低这一群体艾滋病毒风险的政策和计划将防止每年非洲裔美国人及其性网络成员中出现大量新感染。这项研究将确定是否承诺的关系在监禁期间解散是一个风险因素释放后的艾滋病毒性风险行为和药物使用的非洲裔美国男性释放，并将描述通过关系解散可能会影响艾滋病毒风险的途径。研究结果可能会强调需要实施刑事司法政策，减少网络中断，并可能告知艾滋病毒预防干预措施，包括囚犯及其伴侣的监狱计划，促进沟通，防止关系解体，以及释放前的艾滋病毒预防教育，为在监禁期间失去忠诚伴侣的男性。