HIV Risk Reduction for Women with Incarcerated Partners

描述（由申请人提供）：与被监禁的男性伴侣在一起的妇女感染艾滋病毒的风险增加;她们的脆弱性是由她们的伴侣的具体情况赋予的？的监禁。被监禁的男子感染艾滋病毒的可能性比一般人口中的男子高五倍以上（司法统计局，1999年）。有些人在入狱前就接触到了艾滋病毒;另一些人则在入狱期间因共用针头或与他人接触而接触到艾滋病毒。 在监狱里没有安全套和无菌针头的无保护性行为。当被监禁的男子回到家中，与其伴侣发生无保护措施的性行为或共用针头时，其伴侣就有感染的风险。这是一个重大的公共卫生问题，因为目前美国有200多万人被监禁（90%以上是男性），每年有多达1400万人通过刑事司法系统，大多数囚犯在短暂的监禁后被释放。 呆在监狱或监狱里。虽然伴侣被监禁的妇女感染艾滋病毒的风险增加，但没有专门针对这一弱势群体减少艾滋病毒风险的干预研究。 在这项研究中，我们将：（1）开展多方法形成性研究，以完善针对有被监禁男性伴侣的妇女的艾滋病毒风险和降低风险的特定人群理论模型，其中包括个人（错误信息、拒绝和尽量减少风险、隔离）、夫妇（关系压力）和背景（机构政策）因素; 根据修订后的理论模型，对有被监禁伴侣的妇女进行减少艾滋病毒风险的干预;（3）审查干预措施在解决模型风险领域（例如增加准确的信息、社会支持和沟通技能）和减少伴侣从监狱释放后无保护性交和共用针头方面的可行性、可接受性和有效性。 在研究的形成阶段，我们将对20名妇女访问其被监禁的伴侣和15名服务提供者进行定性访谈，并在其伴侣从监狱释放之前和之后对220名妇女进行定量调查，以测试特定人群的艾滋病毒风险模型。干预和工具开发将使用形成性研究结果和社区咨询委员会（CAB）的投入。我们将使用 将采用定性和定量方法来审查干预措施的可行性和可接受性，并通过将125名干预措施参与者与在干预措施队列之前招募和评估的比较样本进行比较，对干预措施的有效性进行初步测试。

DESCRIPTION (provided by applicant): Women with incarcerated male partners are at increased risk for HIV; their vulnerability is conferred by the specific context of their partner?s incarceration. Incarcerated men are over five times more likely than men in the general population to be infected with HIV (Bureau of Justice Statistics, 1999). Some are exposed to HIV before incarceration; others are exposed during incarceration from sharing needles or having unprotected sex in prison where condoms and sterile needles are not available. When incarcerated men return home and have unprotected sex or share needles with their partners, their partners are at risk for infection. This is a major public health issue as there are currently over 2 million people incarcerated in the U.S. (over 90 percent males), up to 14 million people pass through the criminal justice system each year, and most inmates are released after a short stay in prison or jail. Although women with incarcerated partners are at increased risk for HIV, there have been no intervention studies specifically targeting HIV risk reduction for this vulnerable population. In this study, we will: (1) Conduct multi-method formative research to refine a population-specific theoretical model of HIV risk and risk reduction for women with incarcerated male partners that includes individual (misinformation, risk denial and minimization, isolation), couple (relationship pressures), and contextual (institutional policies) factors; (2) Develop a population-specific HIV risk reduction intervention for women with incarcerated partners based on the revised theoretical model; (3) Examine the feasibility, acceptability and effectiveness of the intervention in addressing the risk domains of the model (e.g. increasing accurate information, social support and communication skills) and in reducing unprotected intercourse and needle sharing when partners are released from prison. In the formative phase of the study, we will conduct qualitative interviews with 20 women visiting their incarcerated partners and 15 service providers, and quantitative surveys with 220 women both before and after their partners are released from prison to test a population-specific HIV risk model. Intervention and instrument development will use formative research findings and the input of a Community Advisory Board (CAB). We will use qualitative and quantitative methods to examine the feasibility and acceptability of the intervention, and a preliminary test of intervention effectiveness will be accomplished by comparing the 125 intervention participants with a comparison sample that will be recruited and assessed before the intervention cohort.