Emotion and Relationships Underlying HIV/HCV Risk Among Incarcerated Women

描述（由申请人提供）：尽管她们对艾滋病毒和丙型肝炎（HCV）的脆弱性不成比例，但被监禁的妇女很少成为预防研究的重点。社区中的高危妇女可能难以接触到;因此，监狱提供了一个接触妇女的独特机会，因为她们有时间参与预防方案，而且没有其他紧迫的需要（例如儿童保育、住所、下一顿饭、购买药物）。由于绝大多数女囚将很快返回其社区（Travis，2005年），她们较高的感染率也对公共卫生产生严重影响。最近对艾滋病毒预防干预措施的荟萃分析表明，必须调整目前的风险行为模式，以有效地适应不同人群的需求。由于很少有研究已经进行了监禁妇女，形成性研究，需要确定哪些因素是最有影响力的风险行为，使这些因素可以通过干预措施的目标。拟议的研究涉及一个混合方法的研究，以评估基于社会行动理论（SAT）的被监禁妇女的风险行为模型。SAT扩展了经典的社会认知理论，强调两个主要组成部分：（1）动态健康行动状态;（2）自我改变过程;并结合了人际动态和内部情感状态等背景因素。在目前的研究中，定性深入访谈被监禁的妇女（N = 20）将被用来检查动态的健康行动状态，其中包括与性伴侣的相互依赖性和所采取的行动的后果。在结构化调查中收集的定量数据与被监禁的妇女（N = 200）将被用来测试自我改变的过程，特别是在路径，纳入风险行为的既定认知预测的影响，以及亲密关系控制和心理困扰，对性冒险。这项研究将是研究计划的第一步，最终导致设计一个综合干预措施，将心理健康治疗和风险预防结合起来，在矫正环境中管理。申请人是该国第一临床心理学项目的尖子生，已经获得了监狱和国务院管理人员的支持。她还组建了一个专家小组，为申请人制定了全面的培训计划，并渴望协助实现研究金目标。 公共卫生相关性：这一项目为减少传染病在被监禁妇女中的传播奠定了基础，而被监禁妇女是一个资源匮乏的弱势群体。减少感染既降低了普通公众的感染风险，也降低了疾病治疗的公共卫生费用。

DESCRIPTION (provided by applicant): Despite their disproportionate vulnerability to HIV and Hepatitis C (HCV), incarcerated women are rarely the focus of prevention research. At risk women can be difficult to reach in the community; so prison provides a unique opportunity to gain access to women while they have the time available to engage in prevention programming and are not preoccupied by other immediate needs (e.g. childcare, shelter, next meal, drug acquisition). Since the vast majority of women in prison will soon return to their communities (Travis, 2005), their elevated infection rates also carry serious public health implications. Recent meta-analyses of interventions in HIV prevention have demonstrated that current risk behavior models must be adapted to effectively fit the needs of distinct populations. Since very little research has been conducted with incarcerated women, formative research is needed to establish which factors are most influential in their risk behavior so that these factors can be targeted through interventions. The proposed research involves a mixed-methods study to evaluate a model of risk behavior among incarcerated women based on Social Action Theory (SAT). Expanding upon classic social-cognitive theories, SAT emphasizes two major components: (1) the dynamic health action state; and (2) the self-change process; and incorporates contextual factors like interpersonal dynamics and internal affective states. In the current study, qualitative in-depth interviews with incarcerated women (N = 20) will be used to examine the dynamic health action state, which includes interdependence with a sexual partner and experienced consequences of action taken. Quantitative data collected in structured surveys with incarcerated women (N = 200) will be used to test the self-change process, specifically looking at pathways that incorporate the impact of established cognitive predictors of risk behavior, as well as intimate relationship control and psychological distress, on sexual risk-taking. This study will be the first step in a program of research ultimately leading to the design of a comprehensive intervention that integrates mental health treatment and risk prevention to be administered within correctional settings. The applicant, a top student at the #1 clinical psychology program in the country, has already obtained the support of prison and state department administrators. She has also assembled a team of experts who have devised a comprehensive training plan for the applicant, and are eager to assist in achieving the fellowship goals. PUBLIC HEALTH RELEVANCE: This project provides groundwork for reducing the spread of infectious diseases in incarcerated women, a vulnerable population with few resources. Reducing infections lowers both the risk of infection to the general public and the publicly-funded health costs of disease treatment.