HIV Risk Reduction among Drug Court Offenders

描述（由申请人提供）：药物滥用和成瘾在涉及刑事司法系统的个人中很常见，并导致这一人群中艾滋病毒感染率较高。毒品法庭为被判犯有与毒品有关的指控的人提供了监禁之外的另一种选择，并提供了提供艾滋病毒预防服务的潜在场所。该研究的目的是：1)将最初为男性药物治疗客户开发的基于证据的小群体艾滋病毒风险降低干预措施调整为在药物法庭环境下的个人交付；2)开展横断面调查，评估密西西比州毒品法庭项目中罪犯的HIV/STD性风险行为，评估不同司法地区、罪犯特征（如年龄、种族）、毒品法庭参与时间长短、性风险行为改变的准备程度（改变阶段）以及个人、伴侣、社会和环境障碍对安全性行为的影响；3)在一个密集的毒品法庭项目中进行适应性干预的试点可行性研究。在项目的前14个月，将在四个成人毒品法庭进行适应干预的形成性研究。将与24名毒品法庭和药物治疗人员进行半结构化访谈，以指导干预适应和将干预融入毒品法庭计划。将收集200名毒品法庭罪犯的自我报告量表，以检查拟议措施的心理测量特性，并对这些措施进行预测试，以便在试点可行性研究中使用。在该项目的第二阶段，将在一个单一的毒品法庭进行一项试验性可行性研究。40名男性毒品法庭罪犯将接受适应性干预。试点可行性研究的受试者将在干预前、干预后和干预后3个月对性风险行为、伴侣风险因素、改变的准备程度和安全性行为的社会心理相关因素进行评估。数据分析将评估干预措施的有效性，并确定进行R01申请的适当性，以在充分有力的随机临床试验中测试干预措施。通过证明毒品法庭罪犯需要艾滋病毒预防服务，以及将减少艾滋病毒性风险的干预措施纳入毒品法庭方案，该项目有可能做出重大贡献。

DESCRIPTION (provided by applicant): Substance misuse and addiction are common among individuals involved in the criminal justice system and contribute to higher rates of HIV infection among this population. Drug courts provide an alternative to incarceration for persons who are convicted of drug-related charges and offer a potential venue for providing HIV prevention services. The aims of the proposed study are to 1) adapt an evidence-based small-group HIV risk reduction intervention originally developed for male drug treatment clients for individual delivery in a drug court setting; 2) To conduct a cross-sectional survey to assess HIV/STD sexual risk behaviors of offenders in Mississippi drug court programs assessing differences in risk behavior by judicial district, by offender characteristics (e.g., age, race), by length of drug court participation, readiness to change (stage of change) sexual risk behaviors, and the personal, partner, social, and contextual barriers to safer sexual practices; and 3) to conduct a pilot feasibility study of the adapted intervention within an intensive drug court program. Formative research to adapt the intervention will occur in the first 14 months of the project in four adult drug courts. Semi- structured interviews will be conducted with 24 drug court and drug treatment personnel to guide intervention adaptation and integration of the intervention into the drug court program. Self report measures will be collected from 200 drug court offenders to check the psychometric properties of proposed measures and to pre-test the measures for use in the pilot feasibility study. In the second phase of the project, a pilot feasibility study will be conducted in a single drug court. Forty (40) male drug court offenders will receive the adapted intervention. Subjects in the pilot feasibility study will be assessed at pre-intervention, immediately after the intervention and 3-months post intervention on sexual risk behavior, partner risk factors, level of readiness to change, and psychosocial correlates of safer sex. Data analyses will assess the effectiveness of the intervention and determine the appropriateness of proceeding with an R01 application to test the intervention in an adequately powered randomized clinical trial. The project has the potential of making a significant contribution by demonstrating that drug court offenders are in need of HIV prevention services and that an HIV sexual risk reduction intervention can be integrated into drug court programs. PUBLIC HEALTH RELEVANCE: Participants in drug court programs are a high risk population that is not currently being targeted for HIV risk reduction interventions. This project will examine HIV/STD sexual risk behavior of drug court offenders, and will adapt an evidence-based sexual risk reduction intervention for drug court participants. The project has the potential of making a significant contribution for improving our understanding of HIV risk behaviors and factors thought to influence HIV risk behaviors among this population and for demonstrating that HIV prevention intervention services can be integrated into criminal justice community supervision.