HIV Prevention in Rural Appalachian Jails: Implications for Re-entry Risk Reduction Among Women Who Use Drugs

AIDS Behav. 2018 Dec;22(12):4009-4018. doi: 10.1007/s10461-018-2209-z.

Abstract

Rural women are at risk for health consequences (such as HIV) associated with substance misuse, but targeted interventions are limited for this population. Jails provide an underutilized opportunity for outreach to high-risk women in rural Appalachian communities. Rural women were randomized to either the NIDA Standard education intervention (n = 201) or the NIDA Standard plus motivational interviewing (MI-HIV; n = 199) while in jail. Outcomes focused on HIV risk behaviors 3 months post-release from jail. Decreases in HIV risk behaviors were observed at follow-up across conditions. Although participants in the MI-HIV group showed reductions in outcomes compared to the NIDA Standard group (OR = 0.82-0.93), these estimates did not reach significance (p values > .57). HIV education interventions can be associated with risk-reduction behaviors. These findings support the need for increased access to prevention education in criminal justice venues, particularly in rural communities.

Keywords: Drug use; HIV prevention; Incarceration; Intervention; Rural women.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Appalachian Region / epidemiology
  • Drug Users / psychology*
  • Drug Users / statistics & numerical data
  • Female
  • HIV Infections / epidemiology
  • HIV Infections / prevention & control*
  • HIV Infections / transmission
  • Health Education
  • Humans
  • Middle Aged
  • Motivation
  • Motivational Interviewing
  • Prevalence
  • Prisoners / psychology*
  • Prisons*
  • Risk Reduction Behavior*
  • Risk-Taking*
  • Rural Population* / statistics & numerical data
  • Substance-Related Disorders / complications*
  • Substance-Related Disorders / epidemiology
  • Substance-Related Disorders / psychology
  • Treatment Outcome
  • Unsafe Sex / prevention & control*
  • Unsafe Sex / statistics & numerical data