Women prisoners, many of whom are poor or of color, have disproportionately high rates of HIV andother sexually transmitted diseases. Women prisoners are 15 times more likely to be HIV-infectedthan women in the general population. Prison facilities in the south have among the highest rates ofHIV in the nation. The proposed study will adapt and tailor the existing evidence-based behavioralintervention, 'Project SAFE,' for use with incarcerated women in the south. Project SAFE wasoriginally developed for and tested with women in STD clinics in the urban Southwest.
The specific aims of the project are to: (1) Assess the fit between intervention delivery and the needs andresources of the North Carolina Department Of Corrections and the fit between intervention materialsand the behavioral, social, and contextual conditions of incarcerated women's lives that maycontribute to continuing sexual risk behavior following release from prison; (2) Adapt and tailor theProject SAFE behavioral risk reduction intervention for HIV-negative, heterosexual women prisonersin the rural Southeastern U.S; (3) Pilot the adapted Project SAFE intervention; and (4) Test theadapted Project SAFE risk-reduction intervention with 598 incarcerated women to determine itsefficacy in decreasing risk for non-viral STD infections (chlamydia, gonorrhea, and trichomonas),decreasing sexual risk behaviors and increasing risk reduction practices. A randomized two-groupexperimental design will be used: the experimental group will receive the adapted Project SAFEintervention and the control group will receive standard Department of Corrections counseling aboutSTDs/HIV. Specific hypotheses to be tested are: (1) Women receiving the Project SAFE interventionwill have a lower 12-month rate of non-viral STD infections (chlamydia, gonorrhea, and trichomonas)after release than women who did not receive the intervention; and (2) Women receiving the ProjectSAFE intervention will show greater improvement in enacting sexual protective practices (decreasednumber of unprotected sex acts, decreased number of concurrent sex partners) and decreased highrisk sexual activities (sex with an infected partner, lack of mutual monogamy, unsafe sex, partnerconcurrency, douching after sex, sex exchange for drugs, sex while high) at 3, 6, and 12 months afterrelease than women who did not receive the intervention. Approximately 30%-50% of participants areexpected to live in rural communities and over 40% are expected to be African American.

Public Health Relevance

The proposed study will test an adaptation of an intervention that has been shown to effectively reduce risk behaviors and sexually transmitted diseases in women. The study will adapt the intervention for use with incarcerated women in the south, a population with very high rates of HIV and other sexually transmitted. The primary aim of the study is to develop an intervention that will effectively reduce HIV and STDs in this high risk population.

Project Start
2007-09-30
Project End
2012-09-29
Budget Start
2009-09-30
Budget End
2010-09-29
Support Year
3
Fiscal Year
2009
Total Cost
$443,308
Indirect Cost
Name
University of North Carolina Chapel Hill
Department
Type
Schools of Nursing
DUNS #
608195277
City
Chapel Hill
State
NC
Country
United States
Zip Code
27599
Herbst, Jeffrey H; Branscomb-Burgess, Olivia; Gelaude, Deborah J et al. (2016) Risk Profiles of Women Experiencing Initial and Repeat Incarcerations: Implications for Prevention Programs. AIDS Educ Prev 28:299-311
Fogel, Catherine I; Crandell, Jamie L; Neevel, A M et al. (2015) Efficacy of an adapted HIV and sexually transmitted infection prevention intervention for incarcerated women: a randomized controlled trial. Am J Public Health 105:802-9
Fogel, Catherine I; Gelaude, Deborah J; Carry, Monique et al. (2014) Context of risk for HIV and sexually transmitted infections among incarcerated women in the south: individual, interpersonal, and societal factors. Women Health 54:694-711
Fasula, Amy M; Fogel, Catherine I; Gelaude, Deborah et al. (2013) Project power: Adapting an evidence-based HIV/STI prevention intervention for incarcerated women. AIDS Educ Prev 25:203-15