Sustainable HIV Risk Reduction Strategies for CJ Systems

描述（由申请人提供）：由于缺乏政策制定和刑事司法、卫生和社会服务机构之间的整合，大多数刑事司法治疗系统中不存在完善和持续使用的艾滋病毒/乙型肝炎病毒/丙型肝炎病毒风险降低预防/干预方案，包括护理的连续性。针对社区监管的风险降低干预措施至关重要，因为社区监管过程中存在风险行为。在美国，大约有500万罪犯受到社区监督（司法统计局，2004年），其中41%作为特殊情况接受药物治疗，33%需要进行药物测试（Bonczar， 1997年）。降低社区矫正人群风险的方法需要具有解决动机、社会和认知缺陷的能力。本申请建议：

DESCRIPTION (provided by applicant): Well established and consistent use of HIV/HBV/HCV risk reduction prevention/intervention programs that include continuity of care do not exist in most criminal justice treatment systems because of lack of policy development and integration among criminal justice, health, and social service agencies. Risk reduction interventions targeting community-based supervision are crucial because of the risk behaviors that exist during community supervision. In the U.S., there are approximately 5 million offenders under community supervision (Bureau of Justice Statistics, 2004) with 41% having drug treatment as a special condition and 33% having a drug-testing requirement (Bonczar, 1997). Risk reduction approaches for community corrections populations are needed that have the capability of addressing motivational, social, and cognitive deficits. This application proposes to adapt an in-prison and highly interactive curriculum for improving decision making regarding health risk behaviors for use with offenders under community supervision. The first phase of this proposed continuation project developed and tested an in-prison, group-based curriculum, titled WaySafe, that was designed to help offenders make better decisions regarding health risk behaviors after release back to the community. The next step in our research is to adapt the innovative WaySafe intervention for use with community-corrections populations. The adapted intervention, StaySafe, will include twelve 30 minute self-administered sessions based on evidence-based cognitive principles designed to improve decision-making skills regarding health risk behaviors during the critical first six months under community supervision. StaySafe will be administered to probationers who recently completed a residential, intensive outpatient, or prison-based substance abuse treatment program. It will be delivered during the time they are waiting for their regularly scheduled appointments with their probation officer. An advantage of this approach is that the intervention can be administered to probationers with minimal training and time commitment by staff and that it utilizes probationer down time when they are waiting for appointments. It will utilize tablet computers that allow the intervention to be individualizedto the needs and goals of each participant, and provide an easy to use interface for probationers to complete guide maps and to recall completed assignments from previous sessions. This intervention will be implemented in Harris and Tarrant Counties in Texas utilizing a randomized intervention approach. Participating probationers (N=1,200) will be randomly assigned to an experimental (StaySafe) or standard practice (SP) study arm. Outcome measures at 6 and 12 months will include knowledge and attitudes regarding risk reduction behaviors, engagement in sex and drug risk behaviors, and getting tested for HIV/HBV/HCV.