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

描述（由申请人提供）：本研究的总体目标是了解药物使用和犯罪行为如何与健康差异，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状况中的服务利用率相关。虽然美国各种族群体的药物使用情况相似，但非洲裔美国人因滥用药物而更有可能遭受严重的健康后果和犯罪行为。非洲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。有有限的科学数据，以帮助了解健康差距之间的联系，如艾滋病毒，未经治疗的药物滥用，服务利用的障碍，并作为一个非裔美国女性的刑事犯罪者的地位。这项研究是重要的，因为它的潜力，以确定在健康差距和服务利用之间的差异，非裔美国人的药物使用和非药物使用妇女在选定的水平的刑事司法状况（密集的矫正监督监狱（n = 200），中度矫正监督监狱（n = 200），社区监督缓刑（n=200），没有刑事司法参与（n=200））。所有800名非裔美国女性将接受为期3个月的纵向随访，以检查健康状况和医疗服务的使用情况。具体目标是：（1）描述非裔美国妇女在刑事司法状况和药物使用状况中健康问题的患病率;（2）确定文化，易感性，历史健康和潜在的有利因素，这些因素是非裔美国药物使用和非药物使用妇女在18个月的刑事司法状况中健康问题的预测因素;（3）描述未经治疗的健康问题的患病率，卫生服务利用的模式，以及非裔美国妇女在刑事司法状况和药物使用状况下利用服务的文化障碍;以及（4）检查预测18个月内非裔美国吸毒和非吸毒妇女使用医疗服务的可能性的因素。这项研究的意义包括提供刑事司法系统层面的数据，为预防，干预和治疗非裔美国女性吸毒者的健康规划和卫生政策的潜力。 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状况和药物使用状况方面的健康差距的严重程度，并预测健康状况和随着时间的推移对卫生服务的使用。非洲裔美国女性的这种知识可以作为未来刑事司法系统层面干预措施的基础，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，并减少艾滋病毒风险行为，包括吸毒，无保护性行为和累犯。

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.