Recent estimates place the rate of HIV infection among prisoners at four times that of the general population, or 1.7% (BJS 2006;CDC, 2008ab), and rates of HCV infection is estimated to be between 20 and 40% (CDC, 2003). Latinos account for approximately 31% of all inmates in the United States. As part of NIDA's Criminal Justice Drug Abuse Treatment Studies (CJ-DATS) cooperative agreement, a peer delivered DVD-based intervention for African-American and White criminal justice clients was previously developed and found effective in reducing sexual risk;however, no intervention was developed for Latino offenders. Using a stage model approach and the Information-Motivations-Behavioral (IMB) model, the overall goals of the proposed project is to develop and pilot test a novel, culturally-appropriate HIV/HCV intervention protocol for drug- involved Latino criminal justice clients in Miami, Florida.
The specific aims for the Stage 1a portion of the study are the following: (1) to identify the salient individual and cultural factors that influence HIV/HCV risk and preventive behaviors among heterosexual Latino criminal justice clients through key informant interviews and focus groups;(2) to develop a brief, peer-delivered DVD-based HIV/HCV intervention targeting heterosexual community-based Latino criminal justice clients that include risk factors identified in the formative qualitative research;and (3) to develop and refine an intervention manual and training procedures.
The specific aims for Stage1b are: (1) to pilot test and evaluate the effectiveness of the DVD-based HIV intervention by recruiting 210 Latino offenders mandated to substance abuse treatment;and (2) to evaluate both participant and interventionist acceptability of this novel DVD intervention. Participants will be recruited from a local community agency that provides outpatient substance abuse treatment services for court-mandated individuals. Eligible participants will be self-identified Latino/Hispanic, between the ages of 18 and 49, heterosexual, and all participants will be involved with the criminal justice system. Participants will be randomized into either an intervention or a wait-list control condition. The intervention consists of one DVD-based group session facilitated by an interventionist. Sexual risk, drug use, mental health, and background information will be assessed and HIV/HCV testing provided at baseline, and assessed again at 3 months after the intervention session. At the end of the intervention session, each participant will complete an acceptability questionnaire, and the interventionist will complete a checklist to assess treatment fidelity. It is hypothesized that both sexual risk and drug use behaviors will decrease between baseline and follow-up for the intervention group compared to the control group. The project is innovative because it will develop a DVD-based, culturally-appropriate and language specific, HIV/HCV prevention intervention for Latino offenders. The proposed research is significant, because it is expected to produce a brief HIV/HCV intervention that can be implemented within the criminal justice system and targets a high risk group.
The proposed study is relevant to public health because it focuses on two major public health concerns - HIV/HCV infection;and it also targets a high risk group in drug-involved Latino offenders. Because Latinos are the fastest growing and largest minority group in the United States, the proposed intervention will have a significant impact. The proposed study is relevant to NIDA's mission by addressing the strategic goal of diminishing the spread of drug abuse-related HIV and minimizing the associated health and social consequences of the disease.