Emotion and Relationships Underlying HIV/HCV Risk Among Incarcerated Women

尽管监禁妇女对艾滋病毒和丙型肝炎（HCV）的易感性不成比例，但她们很少成为预防研究的重点。在社区中，有风险的妇女可能很难接触到；因此，监狱提供了一个独特的机会，让妇女有时间参与预防规划，而不是忙于其他紧迫的需求（如儿童保育、住所、下一顿饭、获取药物）。由于监狱中的绝大多数妇女将很快返回她们的社区（Travis， 2005年），她们的感染率上升也带来严重的公共卫生影响。最近对艾滋病毒预防干预措施的荟萃分析表明，必须调整当前的风险行为模型，以有效地适应不同人群的需求。由于对被监禁妇女进行的研究很少，因此需要进行形成性研究，以确定哪些因素对她们的危险行为影响最大，以便通过干预措施针对这些因素。这项拟议的研究涉及一项基于社会行动理论（SAT）的混合方法研究，以评估被监禁妇女的风险行为模型。在经典社会认知理论的基础上，SAT强调两个主要组成部分：(1)动态健康行为状态；(2)自我改变过程；并结合了人际动态和内部情感状态等环境因素。在目前的研究中，将使用对被监禁妇女（N = 20）的定性深入访谈来检查动态健康行动状态，其中包括与性伴侣的相互依赖以及所采取行动的经历后果。通过对被监禁妇女（N = 200）的结构化调查收集的定量数据将用于测试自我改变的过程，特别是研究将风险行为的既定认知预测因素以及亲密关系控制和心理困扰对性冒险的影响结合起来的途径。这项研究将是一个研究项目的第一步，最终导致设计一个综合干预措施，将精神健康治疗和风险预防整合到惩教环境中。申请人是全国排名第一的临床心理学专业的优秀生，已经得到了监狱和国务院管理人员的支持。她还召集了一个专家小组，为申请人设计了一个全面的培训计划，并渴望帮助实现奖学金的目标。

Despite their disproportionate vulnerability to HIV and Hepatitis C (HCV), incarcerated women are rarely the focus of prevention research. At risk women can be difficult to reach in the community; so prison provides a unique opportunity to gain access to women while they have the time available to engage in prevention programming and are not preoccupied by other immediate needs (e.g. childcare, shelter, next meal, drug acquisition). Since the vast majority of women in prison will soon return to their communities (Travis, 2005), their elevated infection rates also carry serious public health implications. Recent meta-analyses of interventions in HIV prevention have demonstrated that current risk behavior models must be adapted to effectively fit the needs of distinct populations. Since very little research has been conducted with incarcerated women, formative research is needed to establish which factors are most influential in their risk behavior so that these factors can be targeted through interventions. The proposed research involves a mixed-methods study to evaluate a model of risk behavior among incarcerated women based on Social Action Theory (SAT). Expanding upon classic social-cognitive theories, SAT emphasizes two major components: (1) the dynamic health action state; and (2) the self-change process; and incorporates contextual factors like interpersonal dynamics and internal affective states. In the current study, qualitative in-depth interviews with incarcerated women (N = 20) will be used to examine the dynamic health action state, which includes interdependence with a sexual partner and experienced consequences of action taken. Quantitative data collected in structured surveys with incarcerated women (N = 200) will be used to test the self-change process, specifically looking at pathways that incorporate the impact of established cognitive predictors of risk behavior, as well as intimate relationship control and psychological distress, on sexual risk-taking. This study will be the first step in a program of research ultimately leading to the design of a comprehensive intervention that integrates mental health treatment and risk prevention to be administered within correctional settings. The applicant, a top student at the #1 clinical psychology program in the country, has already obtained the support of prison and state department administrators. She has also assembled a team of experts who have devised a comprehensive training plan for the applicant, and are eager to assist in achieving the fellowship goals.