Incarceration Effects on Prevention of Drug Use, STI-HIV and Recidivism

被监禁的妇女经常受到童年虐待、暴力和其他困难生活环境的影响 在他们的一生中，通常来自不成比例的弱势社区。 然而，相对较少的研究探讨了邻里特征和监禁与囚犯的风险因素如何相互作用。虽然一些刑事司法研究表明，过度监禁可能会加剧社区的不利条件和不稳定，因为很大一部分居民经常在监狱和社区之间流动，但尚未研究社区不利条件对囚犯健康结果的影响，如吸毒和性风险。此外，虽然女性监禁率在过去20年中稳步上升，但以前的研究主要关注男性，对女性独特的监禁生活轨迹、性风险和吸毒情况了解较少。 本研究旨在探讨监禁对从大型城市监狱返回社区的女囚犯的物质使用、危险性行为和累犯模式的影响和后果。将测试所提出的概念模型，解释与监禁相关的生态因素，以及监禁对吸毒、性病/艾滋病毒风险和女囚犯累犯的影响。为实现这些目标，拟议的研究将开展：1）对监狱中的妇女进行定性深入访谈，探讨她们的监禁经历、社交网络和支助的变化、健康问题、保健和社会服务利用情况、获释后预期面临的挑战以及成功过渡到社区生活的需要; 2）在三个时间点对一组女囚犯进行面对面的纵向调查（监狱中的基线，以及释放后的两周和三个月），以检查主要结果（药物使用复发，STI/HIV感染风险，累犯），次要结局和介质（社会网络，社会支持）; 3）多层次分析和映射，以探索邻里劣势和不稳定性的影响，监禁率和性传播感染率对妇女的影响。

Incarcerated women are often affected by childhood abuse, violence, and other difficult life circumstances throughout their life course, and typically come from disproportionately disadvantaged neighborhoods. However, relatively less research has examined how neighborhood characteristics and incarceration interact with inmates' risk factors. Although several criminal justice studies demonstrated that excessive incarceration may exacerbate community disadvantages and instability as a large proportion of residents constantly move between jail and community, the impact of neighborhood disadvantages on inmates' health outcomes, such as drug use and sexual risks have not been examined. Furthermore, while the rate of female incarceration has steadily increased over the past 20 years, previous studies predominantly concern with men, and women's unique life trajectories of incarceration, sexual risks, and drug use have been less understood. The study proposes to examine the impact and consequences of incarceration on the patterns of substance use, risky sexual behaviors, and recidivism among female inmates who are returning to the community from a large urban jail. The proposed conceptual model will be tested explaining the ecological factors associated with incarceration, and the impact of incarceration on drug use, STls/HlV risks, and recidivism among female inmates. To achieve the objectives, the proposed study will conduct: 1) qualitative in-depth interviews with women in jail exploring their experience with incarceration, changes in social networks and support, health concerns, health care and social services utilization, expected challenges upon release, and needs for successful transition to community life; 2) face-to-face longitudinal surveys with a cohort of female inmates at three time points (baseline in jail, and two weeks and three months post-release) to examine primary outcomes (relapse to drug use, risks for STIs/HlV infection, recidivism), secondary outcomes, and mediators (social network, social support); and 3) multi-level analysis and mapping to explore the effects of neighborhood disadvantage and instability, the rates of incarceration and STIs on women's outcomes.