HIV, Sexually Transmitted Infections
Conditions
Keywords
HIV, STIs, Condom Use, Criminal Justice, Drug Use
Brief summary
The proposed study addresses a significant public health threat of Human immunodeficiency virus (HIV) and sexually transmitted infections (STIs) among drug involved women on probation, parole or other community supervision. This randomized controlled trial aims to test the efficacy of a multimedia version of a 4-session, gender-specific, integrated drug use and HIV/STI prevention intervention (Multimedia Women On the Road To Health (WORTH)) in increasing condom use and decreasing the incidence of sexually transmitted infections (STIs) among 420 drug-involved, female offenders in a large community court setting in New York City, compared to a non-media version of the same intervention (Traditional WORTH) and to a 4-session Wellness Promotion condition.
Detailed description
While it is clear that women inmates in jails and prisons bear a high burden of Human immunodeficiency virus/Acquired Immunodeficiency Syndrome (HIV/AIDS), the effective development of prevention interventions for this high-risk group require an understanding of HIV risk context, sexual behaviors and attitudes for women while they are still in the community and before they become heavily involved in the criminal justice system. HIV prevention interventions must focus on women at early points of entry into the criminal justice system, when they are still in the community and at higher risk of engaging in unsafe sex and drug behaviors. This study focuses on a population of drug-involved women who have been arrested and given a court sanction, but are still living in the community.
Interventions
BEHAVIORALMultimedia WORTH
The Multimedia WORTH intervention features the same core elements as the original version, but these core elements are translated into interactive tools and culturally tailored video vignettes designed to enhance group learning and individualized feedback. Participants will interact with Multimedia WORTH at two levels: (1) group materials will be delivered via computer projection onto a screen and (2) participants will complete individual activities and create journal logs tracking their progress on personalized goals on their personal user accounts using laptop computers. The computer multimedia support tool includes text, imagery, animations, audio and video in a format that guide the facilitator's delivery of the intervention. \*\*\*To view pilot features of the Multimedia WORTH intervention in development, please visit the following web address: http://ccnmtl.columbia.edu/projects/worth/presentation
BEHAVIORALTraditional WORTH
The basic format of each WORTH session remains consistent following a sequence of 5 steps: (1) an opening (quote, song, poem) which will provide a brief culturally relevant point of inspiration to engage participants (2) Check-in to review material from the previous session, and to discuss any incidents where participants engaged in risk behaviors and to acknowledge positive ways in which women used new skills to avoid HIV risk; (3) a discussion to raise awareness of links between IPV, drug-related activities, and HIV risks; (4) a skills-building component relevant to the discussion; and (5) review and update participant needs, homework assigned for skills-building at home, and a closing ritual. The WORTH intervention consists of four 2-hour group sessions that are led by a female facilitator.
BEHAVIORALWellness Promotion
Sponsors
Center for Court Innovation
Bronx Community Solutions
New York City Department of Probation
National Institute on Drug Abuse (NIDA)
Columbia University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
FEMALE
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* She is 18 or older. * She is currently supervised by a criminal justice entity, such as a community court or probation. * She reports engaging in unprotected vaginal or anal sex with a male partner in the past 90 days * She reports any illicit drug use or binge drinking in the past 6 months.
Exclusion criteria
In addition, potential participants will be ineligible if any of the following criteria are met: * Ability to speak and understand English is not sufficient to participate in assessments or intervention sessions. * The woman's sexual activity is limited to a monogamous relationship lasting more than 12 months, and she has not engaged in any of the additional HIV risk behaviors in the past 90 days: * Having sex with more than one partner * Having sex with a partner known or suspected to be HIV positive or an injection drug user (IDU) * Sharing injection drug use needles or equipment * The woman is actively trying to get pregnant/have a baby. * Inability to complete informed consent process due to a psychiatric or cognitive impairment. * The participant was born male.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The proportion of condom protected acts of vaginal and anal intercourse | Up to 12 months |
Secondary
| Measure | Time frame |
|---|---|
| Cumulative incidence of biologically confirmed STIs (Chlamydia, Gonorrhea and Trichomoniasis) | Up to 12 months |
Countries
United States
Outcome results
None listed