Efficacy of an Adapted HIV and Sexually Transmitted Infection Prevention Intervention for Incarcerated Women: A Randomized Controlled Trial

Abstract

Objectives We tested the efficacy of an adapted evidence-based HIV–sexually transmitted infection (STI) behavioral intervention (Providing Opportunities for Women′s Empowerment, Risk-Reduction, and Relationships, or POWER) among incarcerated women. Methods We conducted a randomized trial with 521 women aged 18 to 60 years in 2 correctional facilities in North Carolina in 2010 and 2011. Intervention participants attended 8 POWER sessions; control participants received a single standard-of-care STI prevention session. We followed up at 3 and 6 months after release. We examined intervention efficacy with mixed-effects models. Results POWER participants reported fewer male sexual partners than did control participants at 3 months, although this finding did not reach statistical significance; at 6 months they reported significantly less vaginal intercourse without a condom outside of a monogamous relationship and more condom use with a main male partner. POWER participants also reported significantly fewer condom barriers, and greater HIV knowledge, health-protective communication, and tangible social support. The intervention had no significant effects on incident STIs. Conclusions POWER is a behavioral intervention with potential to reduce risk of acquiring or transmitting HIV and STIs among incarcerated women returning to their communities.

Evaluation of Health Disparity in Bacterial Vaginosis and the Implications for HIV‐1 Acquisition in African American Women

“…37 Incarcerated women have higher rates of HIV and sexually transmitted infections (STI) than the general population. 38 In 2010, 1.9% of incarcerated adult women in the U.S. were HIV positive which is 13 times the rate of adult women in the general population (0.15%). 39 There are approximately 23,000 HIV infected adult women released from correctional institutions annually in the U.S. with the majority being African American women.…”

Educational technologies on sexually transmitted infections for incarcerated women

“…Of the eight studies that were included in the integrative review, five were identified in MEDLINE (25)(26)(27)(28)(29) , one in Cochrane (30) , one in ScienceDirect (31) , and one in CINAHL (32) . Most of the studies were developed in the United States (7) (25)(26)(27)(28)(29)(30)32) and all of them were written in English. Only one article was prepared in Brazil (31) .…”

“…Other resources such as videos and games were also used (27)(28)(29)(30) . These technologies can be built and used to boost the teaching and learning process without the need for Internet access, which favors their use in prison settings.…”

Leveraging the U.S. Criminal Justice System to Access Women for HIV Interventions

“…Among these, 4 HIV interventions explicitly included women-specific and/or trauma-informed content (39–42). Project POWER (Providing Opportunities for Women’s Empowerment, Risk-Reduction, and Relationships), for example, was extensively adapted from a CDC evidence-based intervention (EBI) to include HIV disease knowledge, personal risk recognition, evaluation of behavioral change, self-efficacy, and attainment of skills in 9 facilitator-led sessions prior to release (40). Attrition was high post-release but there was still a significant intervention effect on self-reported condom use, knowledge, health-protective communication, and social support compared to a single HIV prevention session as usual.…”