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HIV Prevention for Women with Incarcerated Male Partners: The HOME Project

HIV Prevention for Women with Incarcerated Male Partners: The HOME Project. CAPS/UCSF: Olga Grinstead (PI), Megan Comfort (Project Director) Angela Allen, Philippe Bourgois, Barbara Garcia, Kelly Knight, Kathleen McCartney, Tor Neilands, Christine Soriano

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HIV Prevention for Women with Incarcerated Male Partners: The HOME Project

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  1. HIV Prevention for Women with Incarcerated Male Partners: The HOME Project CAPS/UCSF: Olga Grinstead (PI), Megan Comfort (Project Director) Angela Allen, Philippe Bourgois, Barbara Garcia, Kelly Knight, Kathleen McCartney, Tor Neilands, Christine Soriano Centerforce: Yolanda Najera, Katie Kramer, Jolene Forman, Barry Zack Funded by National Institute of Nursing Research

  2. Why work with women with incarcerated partners? • June 2004: 726 inmates per 100,000 people, or 1 in every 138 U.S. residents behind bars • 56% of those behind bars are people of color • 2% of state prisoners in the U.S. were known to be infected with HIV in December 2002 • Overall confirmed AIDS rate among U.S. prisoners in 2002 was more than 3 times the rate in the general population (0.48% vs. 0.14%)

  3. Why work with women with incarcerated partners? • Public-health study of low-income African-American women: • 22% had a current sexual partner who had been incarcerated at some point in his life • 5% had a current sexual partner who had been incarcerated for at least 12 months (Source: Battle et. al., (1995) “Accessing an Understudied Population in Behavioral HIV/AIDS Research: Low-Income African-American Women,” Journal of Health & Social Policy, 7(2), 1-17.)

  4. Previous Research with Women with Incarcerated Partners Love Your Man, Love Yourself (1995-1998) We learned: • It is feasible to recruit and follow-up women who visit men in prison • It is feasible to recruit and train peer educators

  5. The HOME Project • Health Options Mean Empowerment • Began in October 2002 • Phase 1: formative research • Phase 2: intervention development • Phase 3: intervention implementation and evaluation

  6. HOME Research Questions • Formative research: what are the HIV risks and needs that women with incarcerated male partners experience? • Intervention Development: how can we address these risks and needs in a population-specific intervention? • Evaluation: can the HOME intervention affect women’s knowledge, behavior, and/or attitudes regarding HIV risk?

  7. Formative Data Collection • Qualitative interviews with women visiting an incarcerated male partner (N=20) • Qualitative interviews with correctional officers (N=13) • Quantitative survey with women visiting an incarcerated male partner (baseline N = 117, 30-day post-release follow-up N=99)

  8. Consistent Findings from Previous and HOME Formative Research • Interventions designed for women with incarcerated male partners are feasible • Women do not feel at risk for HIV because they are monogamous • Lack of knowledge about prison policies diminishes women’s abilities to accurately assess their partners’ HIV risk, e.g., belief that all men are tested for HIV while incarcerated • Unprotected sexual intercourse has emotional and practical importance; partners are not using condoms

  9. The HOME Intervention • Intervention activities are: open to all (mothers, sisters, daughters, friends, as well as partners) • Multi-component approaches: community fairs, small-group workshops, 1-on-1 outreach, warmline • Holistic topics: women’s and children’s health, job skills, parenting, criminal-justice issues, community-building activities • Peer Educators: trained, supervised, and paid to conduct 1-on-1 outreach at prison and in home communities, facilitate HOME activities

  10. The HOME Evaluation Design • Women visiting romantic partners who will be released within intervention period are recruited to be longitudinal study participants: baseline, post-release follow-up • Two qualitative interviews will be conducted with each peer educator • Attendance at HOME intervention activities will be encouraged and recorded for study participants • A cross-sectional survey was conducted before (N=205) and will be conducted again after the year-long intervention to evaluate community-level impact

  11. Acknowledgments • Our study participants – past, present, and future • Centerforce • National Institute of Mental Health, Northern California Grantmakers, National Institute of Nursing Research

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