HIV infection is concentrated within prisons and jails. Further, a substantial proportion of incarcerated individuals engage in behaviors that place them at risk for acquisition of HIV and other sexually transmitted infections (STIs). Compared to incarcerated men, women in prisons and jails have higher rates of HIV and STI. While there are data describing HIV risk behaviors in women, few studies focus on incarcerated women, despite their disproportionate burden of HIV and the opportunity incarceration presents to deliver effective prevention interventions. Further, what differentiates imprisoned women who are HIV-infected from those who are uninfected remains unclear and likely extends beyond basic individual demographic and risk behavior categorizations. In particular, difference in interpersonal and contextual factors may place some of these women at greater risk for HIV/STI infection and deserve scrutiny. Additionally, while the prevalence of HIV among incarcerated women is several-fold higher than in the general population, the incidence of HIV infection among women released from prison has not been described. The studies described in this F32 proposal will: a) describe and characterize the behaviors that risk transmission of HIV and other STIs among women entering a state prison in the US South, b) compare HIV-infected and HIV-uninfected women entering prison based on individual, interpersonal and contextual factors that may influence vulnerability to HIV, c) estimate the incidence of HIV infection among women released from state prison in NC. Lastly, the proposed studies will serve as a vehicle for and augment a comprehensive and intensive training program designed to prepare Dr. Farel to be an independent clinical researcher of behavioral interventions for persons at risk for HIV and STIs.

Public Health Relevance

A better understanding of the determinants of HIV/STI risk among incarcerated women is needed to inform effective interventions to reduce risk of acquisition of these infections. Successful completion of the proposed studies will identify individual, interpersonal, institutional and community factors influencing HIV/STI risk for incarcerated women and estimate their risk of HIV infection after release.

National Institute of Health (NIH)
National Institute on Drug Abuse (NIDA)
Postdoctoral Individual National Research Service Award (F32)
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Special Emphasis Panel (ZRG1-AARR-H (22))
Program Officer
Lambert, Elizabeth
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University of North Carolina Chapel Hill
Internal Medicine/Medicine
Schools of Medicine
Chapel Hill
United States
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Haley, Danielle F; Golin, Carol E; Farel, Claire E et al. (2014) Multilevel challenges to engagement in HIV care after prison release: a theory-informed qualitative study comparing prisoners' perspectives before and after community reentry. BMC Public Health 14:1253
Farel, Claire E; Parker, Sharon D; Muessig, Kathryn E et al. (2013) Sexuality, sexual practices, and HIV risk among incarcerated African-American women in North Carolina. Womens Health Issues 23:e357-64