Relationship Disruption during Incarceration and HIV Risk in African American Men

非裔美国男性监禁期间关系破裂和艾滋病毒风险

• 批准号: 8114996
• 负责人: Maria Rabia Khan
• 金额: $ 55.48万
• 依托单位: UNIV OF MARYLAND, COLLEGE PARK
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-08-01 至 2012-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8114996
• 关键词: AIDS prevention; Accounting; Address; Affect; African American; Alcohols; Anxiety; Automobile Driving; Characteristics; Chlamydia; Cohort Studies; Commit; Communication; Communities; Crime; Criminal Justice; Data; Distress; Drug usage; Economics; Emotional; Enrollment; Epidemic; Face; Feedback; Fostering; Frequencies; Gap Junctions; General Population; Gonorrhea; HIV; Health; Heterosexuals; Home environment; Imprisonment; Incidence; Infection; Injection of therapeutic agent; Intervention; Interview; Lead; Life; Link; Literature; Measurement; Measures; Mediating; Mental Depression; Mental Health; Methods; North Carolina; Outcome; Participant; Pathway interactions; Pattern; Perception; Persons; Pharmaceutical Preparations; Pilot Projects; Policies; Population; Prevention education; Preventive Intervention; Prisons; Privacy; Process; Prospective Studies; Psyche structure; Public Health; Qualitative Research; Race; Recording of previous events; Recruitment Activity; Research; Research Infrastructure; Respondent; Risk; Risk Behaviors; Risk Factors; Schedule; Science; Self Medication; Sexual Partners; Social Environment; Social support; Structure; Surveys; Testing; Time; Trichomonas Infections; Unsafe Sex; Work; base; binge drinking; burden of illness; coping; design; development policy; experience; insight; intimate behavior; male; meetings; member; men; offender; prevent; programs; public health relevance; response; sex; sex risk; sexually active; social; social integration; transmission process

DESCRIPTION (provided by applicant): African American men released from prison face disproportionate HIV risk. Preventing HIV sexual risk behavior and drug use in this group is critical to reducing the race disparity in HIV. However, research on the factors that drive and protect against HIV risk among African American male releasees is limited. Returning to a committed partner after release may be an important protective factor against HIV risk among African American male releasees during reentry. However, incarceration destabilizes committed relationships. Though 50-80% of men enter prison in a committed relationship, we estimate that half of these relationships end by the time of release. Upon release, loss of a partner may lead men to seek multiple, new partners to meet companionship needs or may lead to distress and, in turn, self-medication with drugs or sex. No prior study has evaluated the degree to which partner loss during incarceration influences post-release HIV risk. The present mixed method study is designed to address this gap in the current field of HIV prevention science. This study seeks to examine the hypothesis that dissolution of stable intimate relationships during incarceration elevates sexual risk behavior and drug use among inmates upon their release. The specific aims are: Primary Quantitative Aims: Aim 1. Among African American men in relationships at the time of prison entry, to describe the associations between dissolution of relationships during incarceration and HIV sexual risk behavior (unprotected sex; multiple sex partnerships; buying sex for money or drugs) and drug use (crack use; binge drinking). Aim 2. To assess whether diminished mental health (low coping; increased depression; increased anxiety) due to dissolution of relationships during incarceration results in HIV sexual risk behavior and drug use. Aim 3. To evaluate whether the association between dissolution of relationships during incarceration and HIV sexual risk behavior and drug use varies by respondent and relationship characteristics. Qualitative Aim: To qualitatively explore the social context of post-release and men's perceptions of the factors and processes driving post-release sexual risk behavior and drug use. To accomplish these study aims, we propose to recruit 400 African American male inmates who are scheduled to be released from prison and who were in stable intimate heterosexual relationships at the time of prison entry. Our pilot work suggests that ~50% of relationships will have ended during the incarceration. We will follow men after their release to assess whether post-release sexual risk behavior and drug use are higher among men whose relationships ended during incarceration versus men whose relationships remained intact. The proposed study is designed to inform development of policies and interventions that minimize the destabilizing effects of criminal justice involvement on relationships and health. PUBLIC HEALTH RELEVANCE: Since more than 800,000 African American men are incarcerated in prison at any given time, and hundreds of thousands return home to their communities each year, policies and programs that are effective in reducing HIV risk in this group would prevent substantial numbers of new infections among African American men and members of their sexual networks annually. This research will determine whether dissolution of committed relationships during incarceration is a risk factor for post-release HIV sexual risk behavior and drug use among African American male releasees and will describe the pathways through which relationship dissolution may work to influence HIV risk. Study findings may highlight the need for implementation of criminal justice policies that reduce network disruption and may inform HIV prevention interventions, including in-prison programs for inmates and their partners that foster communication and prevent relationship dissolution, and pre-release HIV prevention education for men who have lost a committed partner during incarceration.

描述（由申请人提供）：从监狱释放的非裔美国人面临不成比例的艾滋病毒风险。预防该组中的艾滋病毒性风险行为和药物使用对于降低艾滋病毒的种族差异至关重要。但是，对非洲裔美国男性释放中推动和预防艾滋病毒风险的因素的研究有限。释放后返回忠诚的伴侣可能是重新进入非洲裔美国男性释放的艾滋病毒风险的重要保护因素。但是，监禁破坏了坚定的关系。尽管有50％至80％的男性在坚定的关系中进入监狱，但我们估计这些关系的一半是在释放之时结束的。释放后，失去伴侣可能会导致男性寻求多个新的伴侣，以满足陪伴需求或可能导致困扰，进而又是用毒品或性行为进行自我治疗。没有先前的研究评估监禁期间伴侣损失的程度会影响释放后的艾滋病毒风险。目前的混合方法研究旨在解决当前艾滋病毒预防科学领域的差距。这项研究试图研究以下假设：监禁期间稳定亲密关系的溶解会提高囚犯释放后的性风险行为和吸毒。具体目的是：主要定量目的：目标1。在入狱时在非洲裔美国人的关系中，在非洲裔美国人的男性中，描述监禁期间的关系解散与艾滋病毒性风险行为的解散与性风险行为（未经保护的性行为；多种性伙伴关系；多种性伙伴关系；购买性别或毒品的性行为）与使用毒品（毒品使用）（破解使用；饮酒；饮酒）。目的2。评估由于被监禁期间的关系解散导致的心理健康是否减少（减轻抑郁症；抑郁症增加）会导致HIV性风险行为和吸毒。目的3。评估监禁期间关系的解散与艾滋病毒性风险行为和药物使用之间的关联是否因受访者和关系特征而有所不同。定性目的：定性地探索释放后的社会背景以及男性对推动释放后性风险行为和吸毒的因素和过程的看法。为了实现这些研究的目的，我们建议招募400名计划从监狱释放并在入狱时处于稳定的亲密异性关系的非裔美国囚犯。我们的飞行员工作表明，在监禁期间，约有50％的关系将结束。在释放后，我们将跟随男性，以评估释放后性风险行为和吸毒的男性在被监禁期间与男性保持完整的男性的男性中是否更高。拟议的研究旨在为制定政策和干预措施提供信息，以最大程度地减少刑事司法参与对人际关系和健康的不稳定影响。 公共卫生相关性：由于在任何给定时间，有80万名非洲裔美国男性在监狱中被监禁，并且每年有成千上万的人返回其社区，因此有效地减少该组艾滋病毒风险的政策和计划将防止非洲裔美国男性中的大量新感染及其性网络的大量新感染。这项研究将确定在监禁期间的解散是在非裔美国人男性释放中释放HIV性风险行为和药物使用的危险因素，并将描述关系解散可能影响HIV风险的途径。研究结果可能会强调实施刑事司法政策的必要性，这些政策减少网络中断并可能为艾滋病毒预防干预措施提供信息，包括针对囚犯及其伴侣的监禁计划，以促进促进交流和防止关系解散，并预防艾滋病毒前的HIV预防艾滋病毒预防教育，以使在监狱期间失去伙伴失去认可的男性。