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男性面临着不成比例的艾滋病毒风险。预防该群体的艾滋病毒性危险行为和吸毒对于减少艾滋病毒的种族差异至关重要。然而，关于非洲裔美国男性被释放者中驱动和预防艾滋病毒风险因素的研究有限。释放后回到忠诚的伴侣可能是非裔美国男性释放者在重返社会期间预防艾滋病毒风险的重要保护因素。然而，监禁会破坏忠诚关系的稳定。尽管 50-80% 的男性入狱时保持着忠诚的关系，但我们估计其中一半的关系在出狱时结束。出狱后，失去伴侣可能会导致男性寻求多个新的伴侣来满足陪伴需求，或者可能导致痛苦，进而导致通过药物或性行为进行自我治疗。之前没有研究评估监禁期间失去伴侣对释放后艾滋病毒风险的影响程度。本混合方法研究旨在解决当前艾滋病毒预防科学领域的这一空白。本研究旨在检验这样一个假设：监禁期间稳定的亲密关系的瓦解会增加囚犯释放后的性危险行为和药物使用。具体目标是： 主要定量目标： 目标 1. 在入狱时处于恋爱关系的非裔美国男性中，描述监禁期间关系解除与艾滋病毒性危险行为（无保护性行为、多重性伙伴关系、买性行为）之间的关联金钱或毒品）和吸毒（快克吸毒；酗酒）。目标 2. 评估因监禁期间关系破裂而导致的心理健康状况恶化（应对能力差、抑郁加剧、焦虑加剧）是否会导致艾滋病毒性危险行为和吸毒。目标 3. 评估监禁期间解除关系与 HIV 性危险行为和吸毒之间的关联是否因受访者和关系特征而异。定性目标：定性探讨释放后的社会背景以及男性对释放后危险性行为和吸毒的因素和过程的看法。为了实现这些研究目标，我们建议招募 400 名即将出狱的非裔美国男性囚犯，他们在入狱时处于稳定的亲密异性恋关系。我们的试点工作表明，约 50% 的关系将在监禁期间结束。我们将在男性出狱后对其进行追踪，以评估在监禁期间关系结束的男性与关系保持完好的男性相比，释放后的性风险行为和吸毒是否更高。拟议的研究旨在为制定政策和干预措施提供信息，以最大限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：由于在任何特定时间都有超过 800,000 名非洲裔美国男性被关押在监狱中，并且每年有数十万人返回自己的社区，因此有效降低该群体艾滋病毒风险的政策和计划将防止大量非洲裔美国男性感染艾滋病毒。每年非洲裔美国男性及其性网络成员中都有新的感染病例。这项研究将确定监禁期间解除承诺关系是否是非裔美国男性获释者出狱后艾滋病毒性行为和吸毒的危险因素，并将描述关系解除可能影响艾滋病毒风险的途径。研究结果可能强调需要实施刑事司法政策，减少网络中断，并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狱内计划，以促进沟通和防止关系破裂，以及针对男性的释放前艾滋病毒预防教育在监禁期间失去忠实伴侣的人。