Delivering HIV Risk Reduction Services in Drug Court

在毒品法庭提供降低艾滋病毒风险的服务

• 批准号: 8415884
• 负责人: DAVID S FESTINGER
• 金额: $ 43.29万
• 依托单位: TREATMENT RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-01-15 至 2015-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8415884
• 关键词: AIDS prevention; AIDS/HIV problem; Accountability; Achievement; Address; Adherence; Admission activity; Adult; Attention; Behavioral; Caring; Case Management; Case Manager; Cities; Client; Communities; Consent; Consultations; Control Groups; Country; Criminal Justice; Drug Courts; Drug usage; Drug user; Effectiveness; Employment; HIV; HIV Infections; HIV risk; Health; Housing; Human immunodeficiency virus test; Imprisonment; Individual; Infection; Injection of therapeutic agent; Intervention; Length; Life; Literature; Measures; Medical; Mentors; Modeling; Outcome; Participant; Patient Self-Report; Pharmaceutical Preparations; Philadelphia; Population; Prevalence; Preventive Intervention; Procedures; Randomized; Resources; Risk; Risk Assessment; Risk Behaviors; Risk Reduction; Sampling; Schedule; Self-Administered; Series; Services; Site; Substance abuse problem; Supervision; System; Testing; Training; United States; Urinalysis; base; brief intervention; computerized; condoms; cost; cost effectiveness; court; design; drug abstinence; effective intervention; group intervention; high risk behavior; improved; intervention effect; offender; primary outcome; programs; public health relevance; recidivism; response; satisfaction; skills; social; transmission process

DESCRIPTION (provided by applicant): There is growing recognition of the substantial burden of HIV infection and the potential for HIV transmission among individuals under the supervision of the criminal justice system. This is, in part, attributable to the high number of drug users under supervision and the close linkages between injection and non-injection drug use and HIV risk behaviors and infection. While there have been a growing number of interventions developed and tested to reduce HIV risk among individuals while they are incarcerated and when they return to the community, few HIV prevention interventions have been tested among the growing numbers of individuals who are diverted to community based supervision and treatment. The proposed study is designed to evaluate the efficacy of a brief, personalized and automated HIV prevention intervention delivered to substance abusing offenders in the City of Philadelphia's drug treatment court program. Despite their well established efficacy in reducing recidivism and drug use (Festinger et al, 2002, Marlowe, Festinger, Dugosh et al., 2007), drug courts have yet to be evaluated in their ability to reduce HIV risk. Given the prevalence of high risk behaviors (e.g., Belenko at al., 2004) and the alarming rates of HIV infection and STIs among criminal offenders (14%-26%: Hammet et al, 2002; Spaulding et al., 2009), drug courts represent an important yet unexplored opportunity to deliver risk reduction interventions. As a centralized component of drug court, case management units typically help clients access adjunctive services and provide consultation on a number of important social and health related issues such as employment, housing, and routine medical care. Although HIV/AIDS risk reduction fits within the domain of services provided by drug court case managers, the addition of more intensive services is constrained by limited staff and resources. Fortunately, there is support for the efficacy of computerized brief interventions for reducing HIV risk (see Noar et al., 2009). We will randomly assign 400 felony drug court participants to receive either a brief computerized HIV intervention or an attention control procedure following their first three case management sessions. We will compare the groups on a number of outcomes including engagement in high risk behaviors, rates of HIV testing, and condom procurement (in addition to condom use measured as a risk behavior). We will also examine the effect of the intervention on drug court related outcomes including case management attendance, graduation rates, and urinalysis confirmed drug use. This study will be the first to examine the efficacy of using a brief, computerized HIV risk reduction intervention in drug courts. Findings will provide useful information on the utility of a practical strategy for reducing HIV risk in the growing population of substance using offenders in our communities. Findings will also have major implications for expanding the focus of drug courts and other community based correction programs beyond reducing criminal recidivism and drug use.

描述（由申请人提供）：人们越来越认识到艾滋病毒感染的巨大负担以及在刑事司法系统监督下的个人之间艾滋病毒传播的可能性。这在一定程度上是由于大量吸毒者受到监管，以及注射和非注射吸毒与艾滋病毒危险行为和感染之间的密切联系。尽管已经制定和测试了越来越多的干预措施来降低个人在被监禁期间和返回社区时的艾滋病毒风险，但在越来越多的被转移到社区监督的个人中，几乎没有测试过艾滋病毒预防干预措施和治疗。拟议的研究旨在评估费城药物治疗法庭项目中向药物滥用罪犯提供的简短、个性化和自动化的艾滋病毒预防干预措施的效果。尽管毒品法庭在减少累犯和吸毒方面具有良好的功效（Festinger 等，2002 年；Marlowe、Festinger、Dugosh 等，2007 年），但毒品法庭降低艾滋病毒风险的能力尚未得到评估。鉴于高风险行为的普遍存在（例如，Belenko 等人，2004 年）以及刑事犯罪者中艾滋病毒感染和性传播感染的惊人比率（14%-26%：Hammet 等人，2002 年；Spaulding 等人，2009 年），毒品法庭是提供减少风险干预措施的重要但尚未探索的机会。作为毒品法庭的集中组成部分，案件管理单位通常帮助客户获得辅助服务，并就就业、住房和常规医疗等许多重要的社会和健康相关问题提供咨询。尽管减少艾滋病毒/艾滋病风险属于毒品法庭案件管理人员提供的服务范围，但增加更密集的服务受到有限的人员和资源的限制。幸运的是，计算机化的简短干预措施对于降低艾滋病毒风险的有效性得到了支持（参见 Noar 等人，2009 年）。我们将随机分配 400 名重罪毒品法庭参与者，让他们在前三个案件管理课程后接受简短的计算机化 HIV 干预或注意力控制程序。我们将比较各组的许多结果，包括参与高风险行为、艾滋病毒检测率和安全套采购（除了作为危险行为衡量的安全套使用情况）。我们还将研究干预措施对毒品法庭相关结果的影响，包括案件管理出勤率、毕业率和尿液分析证实的药物使用情况。这项研究将首次检验在毒品法庭中使用简短的、计算机化的艾滋病毒风险降低干预措施的效果。研究结果将为我们社区中不断增长的吸毒犯罪者提供实用策略，以降低艾滋病毒风险的有用信息。研究结果还将对扩大毒品法庭和其他社区惩戒项目的关注范围，超越减少犯罪累犯和吸毒产生重大影响。