African American Female Drug Users: HIV, Health Disparities, & Criminality

说明(申请人提供)：这项研究的总体目标是了解吸毒和犯罪行为如何与健康差距，特别是艾滋病毒，以及非裔美国人吸毒和非吸毒妇女在刑事司法地位中的服务利用有关。尽管美国不同种族之间的毒品使用情况相似，但非裔美国人更有可能因滥用药物而经历严重的健康后果和犯罪活动。非裔美国女性罪犯可能得不到足够的医疗保健，因为她们经历了种族、阶级、性别和罪犯身份的负担。只有有限的科学数据来帮助理解健康差距之间的联系，如艾滋病毒、未经治疗的药物滥用、服务利用障碍以及非裔美国女性的刑事犯罪地位。这项研究之所以具有重要意义，是因为它有可能查明在某些刑事司法地位级别(密集惩教监督--监狱(n=200)、中等惩教监督--监狱(n=200)、社区监督--缓刑(n=200)和不参与刑事司法(n=200))中，吸毒和不吸毒妇女之间的健康差距和服务利用的差异。所有800名非洲裔美国女性将被纵向跟踪三次6个月的间隔，以检查一段时间内的健康状况和卫生服务的使用情况。具体目标是：(1)描述非裔美国女性在刑事司法地位和吸毒状况下的健康问题的流行情况；(2)确定在18个月以上的刑事司法地位中非裔美国人吸毒者和非吸毒者中健康问题的文化、易感、历史健康和潜在的促进因素；(3)描述非裔美国人女性在刑事司法地位和吸毒状况下未接受治疗的健康问题的流行率、卫生服务利用的模式以及服务利用的文化障碍；以及(4)检查在刑事司法地位超过18个月的非裔美国吸毒和非吸毒妇女中预测使用卫生服务的可能性的因素。这项研究的意义包括有可能为预防、干预和治疗非裔美国女性吸毒者的卫生规划和卫生政策提供刑事司法系统层面的数据。 这项研究对公共卫生领域具有重要意义，因为它有可能了解非裔美国妇女在刑事司法地位和药物使用状况方面的健康差距的严重性，并预测随着时间的推移健康状况和卫生服务的使用情况。对非裔美国女性的这种了解可以作为未来刑事司法系统一级干预措施的基础，以增加预防性医疗保健的使用，从而减少对昂贵医疗服务的需求，以及减少艾滋病毒危险行为，包括吸毒、无保护的性行为和再次犯罪。

DESCRIPTION (provided by applicant): The overall goal of this study is to understand how drug use and criminality are related to health disparities, particularly HIV, and service utilization among African American drug using and non-drug using women across criminal justice status. While drug use is similar across racial groups in the US, African Americans are disproportionately more likely to experience severe health consequences and criminal involvement as a result of drug misuse. Adequate health care may not be received by African American female offenders because they experience the burden of their race, class, gender, and criminal offender status. There is limited scientific data to help understand the linkages between health disparities such as HIV, untreated drug abuse, barriers to service utilization, and status as a criminal offender among African American females. This study is significant because of its potential to identify differences in health disparities and service utilization among African American drug using and non-drug using women in selected levels of criminal justice status (intensive correctional supervision-prison (n=200), moderate correctional supervision-jail (n=200), community supervision-probation (n=200), and no criminal justice involvement (n=200)). All 800 African American females will be followed longitudinally for three 6-month intervals to examine health status and the use of health services across time. The specific aims are: (1) To describe the prevalence of health problems among African American women across criminal justice status and drug use status; (2) To determine the cultural, predisposing, historical health, and potential enabling factors that are predictors of health problems among African American drug using and non-drug using women across criminal justice status over 18 months; (3) To describe the prevalence of untreated health problems, the patterns of health services utilization, and the cultural barriers to service utilization among African American women across criminal justice status and drug use status; and (4) To examine the factors that predict the likelihood of using health services among African American drug using and non-drug using women across criminal justice status over 18 months. The significance of this study includes the potential to provide criminal justice systems-level data for health planning and health policy for prevention, intervention, and treatment of African American female drug users. This study is significant to the public health field because of its potential to understand the severity of health disparities among African American women across criminal justice status and drug use status and to predict health status and the use of health services over time. This knowledge of African American females can be used as a foundation for future criminal justice systems-level interventions to increase the use of preventative health care and subsequently reduce the need for expensive medical services, as well as to decrease HIV risk behaviors including drug use, unprotected sex, and recidivism.