DVD-based HIV/HCV Intervention for Drug-Involved Latino Criminal Justice Clients

描述（由申请人提供）：最近的估计表明，囚犯中的艾滋病毒感染率是一般人群的四倍，即1.7%（BJS，2006年; CDC，2008年ab），估计丙型肝炎病毒感染率在20%至40%之间（CDC，2003年）。拉丁裔约占美国囚犯总数的31%。作为NIDA的刑事司法药物滥用治疗研究（CJ-DATS）合作协议的一部分，同行提供的DVD为非洲裔美国人和白色刑事司法客户的干预措施，以前开发，并发现有效地减少性风险，但是，没有干预措施是为拉丁美洲罪犯。使用阶段模型方法和信息-动机-行为（IMB）模型，拟议项目的总体目标是为佛罗里达迈阿密的拉丁裔刑事司法客户开发和试点测试一种新的、文化上适当的艾滋病毒/丙型肝炎病毒干预方案。该研究的第1a阶段部分的具体目标如下：（1）通过关键线人访谈和焦点小组，确定影响拉丁美洲异性恋刑事司法客户中艾滋病毒/丙型肝炎风险和预防行为的突出个人和文化因素;（2）制定一份简报，针对异性恋社区的基于DVD的同伴提供的艾滋病毒/HCV干预措施-（3）制定和完善干预手册和培训程序。第1b阶段的具体目标是：（1）通过招募210名被授权接受药物滥用治疗的拉丁美洲罪犯，对基于DVD的艾滋病干预措施的有效性进行试点测试和评估;（2）评估参与者和干预者对这种新型DVD干预措施的接受程度。参与者将从当地社区机构招募，该机构为法院授权的个人提供门诊药物滥用治疗服务。符合条件的参与者将是自我认定的拉丁裔/西班牙裔，年龄在18岁至49岁之间，异性恋，所有参与者都将参与刑事司法系统。参与者将被随机分配到干预或等待列表控制条件中。干预包括一个基于DVD的小组会议，由一名干预者主持。将评估性风险、药物使用、心理健康和背景信息，并在基线时提供HIV/HCV检测，并在干预后3个月再次评估。在干预会议结束时，每个参与者将完成一份可接受性问卷，干预者将完成一份检查表，以评估治疗的保真度。据推测，与对照组相比，干预组的性风险和药物使用行为在基线和随访之间都会降低。该项目具有创新性，因为它将为拉丁美洲罪犯制定一项基于DVD的、适合文化和语言的艾滋病毒/丙型肝炎预防干预措施。拟议的研究意义重大，因为预计它将产生一个简短的艾滋病毒/丙型肝炎病毒干预措施，可以在刑事司法系统内实施，并针对高危群体。

DESCRIPTION (provided by applicant): Recent estimates place the rate of HIV infection among prisoners at four times that of the general population, or 1.7% (BJS 2006; CDC, 2008ab), and rates of HCV infection is estimated to be between 20 and 40% (CDC, 2003). Latinos account for approximately 31% of all inmates in the United States. As part of NIDA's Criminal Justice Drug Abuse Treatment Studies (CJ-DATS) cooperative agreement, a peer delivered DVD-based intervention for African-American and White criminal justice clients was previously developed and found effective in reducing sexual risk; however, no intervention was developed for Latino offenders. Using a stage model approach and the Information-Motivations-Behavioral (IMB) model, the overall goals of the proposed project is to develop and pilot test a novel, culturally-appropriate HIV/HCV intervention protocol for drug- involved Latino criminal justice clients in Miami, Florida. The specific aims for the Stage 1a portion of the study are the following: (1) to identify the salient individual and cultural factors that influence HIV/HCV risk and preventive behaviors among heterosexual Latino criminal justice clients through key informant interviews and focus groups; (2) to develop a brief, peer-delivered DVD-based HIV/HCV intervention targeting heterosexual community-based Latino criminal justice clients that include risk factors identified in the formative qualitative research; and (3) to develop and refine an intervention manual and training procedures. The specific aims for Stage1b are: (1) to pilot test and evaluate the effectiveness of the DVD-based HIV intervention by recruiting 210 Latino offenders mandated to substance abuse treatment; and (2) to evaluate both participant and interventionist acceptability of this novel DVD intervention. Participants will be recruited from a local community agency that provides outpatient substance abuse treatment services for court-mandated individuals. Eligible participants will be self-identified Latino/Hispanic, between the ages of 18 and 49, heterosexual, and all participants will be involved with the criminal justice system. Participants will be randomized into either an intervention or a wait-list control condition. The intervention consists of one DVD-based group session facilitated by an interventionist. Sexual risk, drug use, mental health, and background information will be assessed and HIV/HCV testing provided at baseline, and assessed again at 3 months after the intervention session. At the end of the intervention session, each participant will complete an acceptability questionnaire, and the interventionist will complete a checklist to assess treatment fidelity. It is hypothesized that both sexual risk and drug use behaviors will decrease between baseline and follow-up for the intervention group compared to the control group. The project is innovative because it will develop a DVD-based, culturally-appropriate and language specific, HIV/HCV prevention intervention for Latino offenders. The proposed research is significant, because it is expected to produce a brief HIV/HCV intervention that can be implemented within the criminal justice system and targets a high risk group.