HIV RISK REDUCTION FOR INCARCERATED WOMEN

描述（改编自摘要）：被监禁的妇女在 以贫困、吸毒和高吸毒率为特点的地理区域 性传播疾病（STD）有感染艾滋病毒的风险， 由于吸毒和无保护的性行为作为商业和非商业 伙伴报告的被监禁妇女艾滋病毒血清阳性率 全国范围内从3.2%的低点到35%的高点， 性病和艾滋病高发地区报告的百分比 与注射毒品或快克使用和异性性行为有关的感染 传输来自美国各地监狱和监狱的数据也显示， 女囚的血清反应阳性率高于被监禁者。 男性同行在本修订申请中， 研究者建议：（1）实施和评估八届 基于社会认知理论的艾滋病毒风险降低干预 和性别与权力理论（TGP），150名被监禁妇女;（2） 将干预与平行生活技能（LS）干预进行比较 这是集中在相同的技能，但针对毒品使用， 150名被监禁妇女的同等样本;（3）评估扩散到 150名未接受任何干预但 被安置在参与实验的妇女附近 干预措施;（4）将结果与仅含信息对照进行比较 150名被监禁的妇女;（5）进行纵向 通过跟踪妇女从监狱释放后18个月的评估， 监狱，以评估干预措施的比较影响， 妇女重新融入社会。研究者假设 基于SCT/TGP的艾滋病毒风险降低干预措施将（1） 提高妇女对艾滋病毒/艾滋病的认识、自我效能、态度 对预防的态度，赞成使用避孕套的态度，对社会 对预防行为的支持，对脆弱性的认识， 安全套使用技能，（2）降低对安全套使用障碍的认识;（3） 在监狱中更多地交换避孕套兑换券 （4）在治疗期间，无保护的性活动率较低 他们的监禁和释放后回到社区 在18个月的随访期内， 扩散或信息条件。此外，研究者 预测（1）在角色扮演中评估的社会能力技能得到改善 SCT和LS参与者相对于扩散和 仅提供信息的条件，以及（2）向监狱人口的传播 这反映在纸笔上的变化幅度较小， 与接受治疗的妇女居住在一起的妇女完成的措施 实验干预。此外，她还假设， SCT/TPR和LS干预将降低百万动力的得分 控制子量表，并在更大程度上减少共用针头 无论是扩散还是仅信息条件。通过实验 评估理论驱动的风险降低的影响 干预，将其结果与平行的技能培训进行比较 与艾滋病毒或艾滋病无关干预措施和仅提供信息的控制措施 在这种情况下，这项研究的研究人员将评估在多大程度上， 在惩教机构实施的方案推广到监狱， 人口最后，在18个月的纵向评估中， 在监狱释放后，研究人员将确定 参与每种情况都与风险降低有关 释放后的行为回到社区。

DESCRIPTION (adapted from the Abstract): Incarcerated women in geographic areas characterized by poverty, drug use, and high rates of sexually-transmitted diseases (STD's) are at risk for HIV infection as a result of drug use and unprotected sex as commercial and non-commercial partners. Reported HIV seroprevalence rates among incarcerated women across the country vary from a low of 3.2% to a high of 35%, with higher percentages reported from areas that have high rates of STD's and HIV infection associated with injection drug or crack use and heterosexual transmission. Data from prisons and jails across the US also reveal that female inmates are seropositive at higher rates than their incarcerated male counterparts. In this revised application the Principal Investigator proposes to: (1) implement and evaluate an eight-session HIV-risk reduction intervention based on Social Cognitive Theory (SCT) and the Theory of Gender and Power (TGP) with 150 incarcerated women; (2) compare the intervention against a parallel life skills (LS) intervention that is focused on the same skills but is targeted on drug use with an equivalent sample of 150 incarcerated women; (3) assess diffusion into a sample of 150 women who do not receive either intervention but are housed in proximity to women who participate in the experimental interventions; (4) compare outcome against an information-only control group of 150 incarcerated women; and (5) conduct a longitudinal evaluation by following the women for 18 months after their release from prison to assess the comparative impact of the interventions during the women's reintegrations into the community. The Investigator hypothesizes that the HIV risk reduction intervention based on SCT/TGP will (1) increase the women's knowledge of HIV/AIDS, self-efficacy, attitudes toward prevention, attitudes favoring condom use, perceptions of social support for precautionary behavior, perceptions of vulnerability, and condom use skills, (2) lower perceptions of barriers to condom use; (3) produce greater exchange of condom redemption coupons at the prison infirmary; and (4) lower rates of unprotected sexual activity during their incarceration and after their release back into the community through an 18-month follow-up period to a greater extent than the LS, Diffusion, or Information conditions. In addition, the Investigator predicts (1) improved social competency skills assessed in role play simulations for the SCT and LS participants relative to the diffusion and information-only conditions, and (2) diffusion into the prison population that is reflected by changes of lower magnitude on paper-and-pencil measures completed by women housed in proximity to the women receiving the experimental interventions. Additionally, she hypothesizes that both the SCT/TPR and LS interventions will lower scores on the Million Impulse Control subscale and reduce needle-sharing to a greater extent than either the diffusion or information only conditions. By experimentally evaluating the impact of a theoretically-driven risk reduction intervention, comparing its outcome against a parallel skills training intervention unrelated to HIV or AIDS and an information-only control condition, the researchers in this study will assess the extent to which programs delivered in correctional facilities generalize into the prison population. Finally, in their longitudinal assessment for 18-months after prison release the researchers will identify the extent to which participation in each condition is associated with risk reduction behavior after release back into the community.