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: 8702126
• 负责人: Maria Rabia Khan
• 金额: $ 49.71万
• 依托单位: NEW YORK UNIVERSITY SCHOOL OF MEDICINE
• 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 2016-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8702126
• 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，对非裔美国男性释放者中艾滋病毒风险驱动和保护因素的研究是有限的。在释放后回到一个忠诚的伴侣身边可能是非洲裔美国男性释放者在重返监狱期间预防艾滋病毒风险的一个重要保护因素。然而，监禁破坏了忠诚的关系。虽然50-80%的男性入狱时都有一段忠诚的关系，但我们估计，其中一半的关系在释放时结束了。在释放后，失去伴侣可能会导致男性寻找多个新的伴侣来满足陪伴需求，或者可能会导致痛苦，进而通过药物或性行为自我治疗。之前没有研究评估过监禁期间失去伴侣对释放后艾滋病毒风险的影响程度。目前的混合方法研究旨在解决当前艾滋病预防科学领域的这一差距。本研究旨在检验一种假设，即在监禁期间稳定的亲密关系的解除会增加囚犯释放后的性风险行为和吸毒。具体目标是：主要定量目标：目标1。在非洲裔美国男性入狱时的恋爱关系中，描述在监禁期间关系的解除与艾滋病毒性风险行为（无保护的性行为；多个性伙伴关系；为金钱或毒品购买性行为）和吸毒（快克使用；酗酒）之间的联系。目标2。评估监禁期间关系破裂导致的精神健康状况下降（应对能力低下；抑郁增加；焦虑增加）是否会导致艾滋病毒性风险行为和吸毒。目标3。评估监禁期间关系破裂与HIV性风险行为和药物使用之间的关系是否因被调查者和关系特征而异。定性目的：定性地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认知。为了完成这些研究目标，我们建议招募400名即将从监狱释放的非裔美国男性囚犯，他们在入狱时处于稳定的亲密异性恋关系中。我们的试点工作表明，大约50%的关系将在监禁期间结束。我们将对获释后的男性进行跟踪调查，以评估在监禁期间关系结束的男性与关系保持完整的男性相比，释放后的性风险行为和吸毒是否更高。拟议的研究旨在为制定政策和干预措施提供信息，尽量减少刑事司法介入对关系和健康的不稳定影响。