HIV Prevention in Rural Appalachian Jails: Implications for Re-entry Risk Reduction Among Women Who Use Drugs

Abstract

Rural women are at risk for health consequences (such as HIV) associated with substance misuse, but targeted interventions are limited for this population. Jails provide an underutilized opportunity for outreach to high-risk women in rural Appalachian communities. Rural women were randomized to either the NIDA Standard education intervention (n = 201) or the NIDA Standard plus motivational interviewing (MI-HIV; n = 199) while in jail. Outcomes focused on HIV risk behaviors 3 months post-release from jail. Decreases in HIV risk behaviors were observed at follow-up across conditions. Although participants in the MI-HIV group showed reductions in outcomes compared to the NIDA Standard group (OR = 0.82-0.93), these estimates did not reach significance (p values > .57). HIV education interventions can be associated with risk-reduction behaviors. These findings support the need for increased access to prevention education in criminal justice venues, particularly in rural communities.

The condom purchase task: A hypothetical demand method for evaluating sexual health decision‐making

“…Specifically, condom demand decreased more rapidly with increased cost for individuals reporting higher AUDIT scores and a recent history of unprotected sexual activity, whereas condom demand decreased less rapidly for participants with greater STI knowledge. Previous research has documented the benefits of educational interventions targeting improved HIV knowledge to decrease risky sexual behaviors and increase intentions to engage in condom‐protected sex, including studies in high‐risk populations (e.g., individuals reporting nonmedical opioid use; Dunn et al, ; Festinger, Dugosh, Kurth, & Metzger, ; Medley, Kennedy, O'Reilly, & Sweat, ; Staton et al, ). The current findings suggest that one mechanism by which improved STI knowledge could enhance sexual health is by reducing sensitivity to the barriers/costs of protected sexual activity (like price).…”

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) .…”

“…A chart was created to summarize the main characteristics of the studies (Figure 3). Staton, et al, 2018 (25) United States…”

“…The others were associated with the health area. As for the type of study, five were randomized clinical trials ( 25 - 26 , 30 - 32 ) and three were descriptive studies ( 26 , 31 - 32 ) .…”

“…The educational technologies used on STIs for incarcerated women were printed materials with two interventions with this type of material associated with genital organ simulators ( 31 - 32 ) , followed by video ( 28 - 30 ) and games ( 27 ) . It should be noted that the educational technologies described were not used in isolation, but as part of an educational intervention that involved, for example, group ( 26 , 29 , 31 ) sessions or combinations of group and individual sessions ( 25 , 32 ) . Regarding the types of STIs, HIV was the object of two technologies ( 26 , 28 ) and one study addressed HIV and the Hepatitis C virus ( 25 ) .…”