Drug Policy, Incarceration, Community Re-entry, and Race Disparities in HIV/AIDS

描述（由申请人提供）：此申请是对去年提交的申请的修订，以响应PAR-07-379，“理解和减少健康差距的行为和社会科学研究”。我们将分析美国毒品政策产生的强制性流动（刑事司法系统与社区之间的大规模移民）与康涅狄格州毒品罪犯样本中hiv相关性风险的种族差异之间的相互关系。此外，我们将研究强制流动（CM）与hiv相关性风险之间的关联是否受到这些罪犯所在社区的社会解体程度的影响。我们还将研究招募和跟踪这些个体的性伴侣的可行性，以更好地了解CM对性伴侣hiv相关风险的影响。我们假设CM以多种不同的方式产生HIV风险的种族差异：1)黑人比白人更有可能被监禁，因此与CM相关的HIV相关性风险可以产生HIV风险的种族差异，即使CM对黑人和白人的影响是相同的；2)黑人比白人更有可能居住在社区中，因此在一定程度上，社会混乱加剧了社区管理的影响，对黑人的HIV风险的影响大于白人；3)黑人的性伴侣更有可能来自这些社会组织混乱的社区，这进一步加剧了CM对回归囚犯及其伴侣的负面影响，并导致了女性艾滋病毒风险的种族差异；4)黑人更有可能受到毒品政策的惩罚，这增加了他们在监狱和社区之间的流动，也增加了他们受到相关伤害的脆弱性。我们还假设我们将能够招募和保留研究参与者的性伴侣，并对CM对其hiv相关性风险的影响进行探索性分析。一个活跃的社区咨询委员会，包括政策制定者和项目管理者，将根据研究结果帮助我们确定结构性干预措施，以减少艾滋病毒的种族差异。公共卫生相关性：本研究将研究美国毒品政策、强制性流动（大量移民进出刑事司法系统）和艾滋病毒相关性风险的种族差异之间的相互联系。它将提出潜在的结构性干预措施，以解决监狱和社区之间的流动问题，包括药物政策改革，有可能减少艾滋病毒/艾滋病方面的种族差异。

DESCRIPTION (provided by applicant): This application is a revision of an application submitted last year in response to PAR-07-379, "Behavioral and Social Science Research on Understanding and Reducing Health Disparities." We will analyze the interconnections between coercive mobility (the massive migration between the criminal justice [CJ] system and the community) produced by US drug policies and race disparities in HIV-related sexual risk among a sample of drug offenders in Connecticut (CT). Further, we will examine whether the association between coercive mobility (CM) and HIV-related sexual risk is affected by the degree of social disorganization in the communities in which these offenders reside. We also will study the feasibility of recruiting and following sexual partners of these individuals to better understand the impacts of CM on partners' HIV-related risk. We hypothesize that CM produces race disparities in HIV risk in a number of distinct ways: 1) Blacks are more likely than Whites to be incarcerated, so HIV-related sexual risk associated with CM can produce race disparities in HIV risk even if the effects of CM are the same for both Blacks and Whites; 2) Blacks are more likely than Whites to reside in communities experiencing the disorganizing impacts of CM, so to the extent that social disorganization exacerbates the effects of CM, it will affect the HIV risks of Blacks to a greater degree than Whites; 3) The sexual partners of Blacks are more likely to come from these same socially disorganized communities, furthering the negative impacts of CM for both returning inmates and their partners, and contributing to race disparities in HIV risk among women; and 4) Blacks are more likely to be penalized by drug policies in ways that increase their movement between prison/jail and the community and their vulnerability to its associated harms. We also hypothesize that we will be able to recruit and retain the sexual partners of study participants and conduct exploratory analyses of the impact of CM on their HIV-related sexual risk. An active Community Advisory Board including policymakers and program administrators will assist us in identifying structural interventions to reduce race disparities in HIV based on study findings. PUBLIC HEALTH RELEVANCE: This research will examine the interconnections among drug policies in the US, coercive mobility (massive migration in and out of the criminal justice system), and race disparities in HIV-related sexual risk. It will suggest potential structural interventions for addressing the movement between prison/jail and the community, including drug policy reforms, with the potential to reduce race disparities in HIV/AIDS.