The rate of HIV infection in jail inmates is between four to six times higher than the national average, and African-American men are disproportionately affected. Over half of the people taken into custody have a history of substance abuse or high-risk sexual behavior, which increases their risk of HIV or other sexually transmitted infections (STIs). To reach inmates with HIV/STI education, more research is needed on their HIV knowledge and risk behaviors.
Georgia has the fifth-largest correctional system in the country and had the seventh-highest number of HIV/AIDS cases in the United States in 2006. Researchers are attempting to decrease inmates’ risky sexual behaviors before the inmates return to their communities. The intervention is delivered in the Atlanta City Detention Center to inmates with a history of drug abuse who have been jailed for 48 hours to one month.
In a pilot test, inmates are interviewed by peer educators (PEs)—African-American men recruited from the community—about sexual practices and barriers to adopting HIV risk-reduction behaviors. PEs work with inmates to discuss a post-release plan for housing, control of substance use, employment, and other issues. PEs monitor participants’ progress over the first few weeks following release from jail.
Data from this study will be used to create an intervention for the inmate population to prevent STIs and HIV infections associated with drug use and unsafe sexual behavior. Participants will receive 12 educational modules over six weeks led by a PE facilitator on HIV knowledge, risk reduction, beliefs about condoms, safe-sex partner conversations, and social support. The 90-minute modules are delivered twice a week and are taught both during incarceration and after release. Each participant is placed in one of seven intervention groups and receives 12 modules but each group varies in the number of modules delivered during jail time and in the community.
Researchers survey participants before the intervention, directly after, and 3 and 6 months later to determine changes in HIV/AIDS knowledge, drug use, sexual behaviors, perceptions of the consequences of drug use, and attitudes toward using condoms. Results from each of the seven intervention groups are compared with each other, to see if number of modules delivered in the jail or the community affects knowledge, perceptions, and behaviors and if a certain number of modules received during jail time promotes higher attendance for the program after release. The results of each intervention group are also compared with those from a group of inmates who do not receive the intervention.