Overview and Inventory of HHS Efforts to Assist Incarcerated and Reentering Individuals and their Families . HIV/AIDS Prevention for Women Sexually Involved with an Incarcerated or Recently Released Incarcerated Heterosexual Partner

02/01/2011

Type of Activity: Demonstration and program services

Description: Aims to increase the number of community linkages and networks for ensuring continuum of care for women sexually involved with an incarcerated or recently released incarcerated heterosexual partner at high-vulnerability for HIV/AIDS. The activity emphasis areas include:

  • Conducting gender specific multi-session interventions which include topics such as female body, condom negotiation skills, and accurate information on STDs.
  • Emphasis on healthy living awareness and skills building.
  • Communications with incarcerated or recently released male partner on healthy living in prison setting (tattooing, injecting drugs, health screening needs).
  • Vulnerabilities and risks specific to females: body, untreated STDs, violence, self-perceived financial dependency, etc.

Funding Mechanism: Competitive Cooperative Agreements

Total Available Funding: $1,200,000 [Minority AIDS Initiative funds – continuation to Aug 2012]

Number of Awards: 8

Average Award Amount per Year: $125,000

Length of Project Period:  3 years; September 2009 – September 2012

Federal Partners:

  • Office of HIV/AIDS Policy
  • Regional Offices
  • Criminal Justice System in the locations [ Houston, TX, Baltimore, Los Angeles, New Jersey, and New York]

Summary: To develop and sustain comprehensive HIV/AIDS/STD prevention and support services for women sexually involved with an incarcerated or recently released incarcerated heterosexual partner in collaboration with health entities, care providers, social services, correctional facilities, community resource organizations, and criminal justice offices.

  • Use of gender-specific, multi-component intervention (e.g. Female and Culturally Specific Negotiation Intervention, “light”, Project Connect, Project FIO, START, WHP, CHOICES, Voices/Voces, etc.) using existing curriculum as written or adaptation to meet needs of target population or newly developed interventions with core elements of effective programs;
  • Employ a gender responsive strategy (e.g. address issues that reduce participation of women: childcare, transportation, confidentiality, family, intimate partner violence, sexual assault, isolation, coercion, poverty, illiteracy, financial dependency, and other dynamics that disproportionately impact women and girls.)
  • Provide accurate prevention education in a culturally and linguistically appropriate manner without condescension.
  • Identify women through but not limited to the visiting centers within correctional facilities and family assistance organizations serving families of incarcerated individuals

Background:

The purpose of this program is to establish gender centered HIV prevention model for women sexually involved with an incarcerated or recently released incarcerated heterosexual partner. Program intent and design mandates working with viable local health departments and/or Community AIDS Service organizations.

According to CDC’s most recent HIV infection data in the U.S. populations, the HIV incidence rate for black women is 15 times as high as that of white women (Estimated rate of new HIV infection: Black Women, 55.7 per 100,000; Hispanic/ Latino Women, 14.4 per 100,000; White Women, 3.8 per 100,000). In 2004, 74 percent of new HIV/AIDS cases for Women were due to heterosexual contact. Women of color represent the majority of new AIDS cases and have been affected disproportionately by the epidemic since its beginning. According to the most recent new HIV infection data, incidence among women declined in the early 1990’s but has remained relatively stable thereafter.

According to M. Comfort et al, (2005), build-up sexual tension and conditions of parole promote unprotected sexual intercourse and other HIV/STD risk behavior following release from prison. In 2006, high-risk heterosexual contact (31 percent) is the second leading cause of new HIV infections to Male-to-Male Sexual Contact (53 percent). HIV, STDs and other infectious diseases are much more prevalent among correctional inmates than in the total U.S. population. Approximately one fourth of all people in he U.S. who are living with HIV or AIDS in a given years pass through the correctional facility that same year.

Prisons have been described as the epicenter for new HIV infections. As of 2007, 2,299,116 persons were held in federal or state prisons or in local jails, an increase of 1.8% from year end 2006. At mid-year 2007, there were 4.618 black male sentenced prisoners per 100,000 black males in the U.S. , compared to 1,747 Hispanic male sentenced prisoner per 100,000 Hispanic males and 773 white male sentenced prisoners per 100,000 white males. In 2006, an estimated 21,980 state and federal inmates (male 19,842; female 2,138) were known to be HIV positive or to have confirmed AIDS. New York (3,650) reported the largest number of male HIV-positive inmates, followed by Florida (3,041), and Texas (2,409). Florida (371) reported the largest number of female HIV-positive inmates, followed by New York (350), and Texas (284). One state— New York (6%)—reported that over 5% of its male inmate population was known to be HIV positive. Three states— New York (12.2%), Florida (7.6%), and New Jersey (7.6%)—reported that over 5% of their female inmates were HIV positive.

Lack of knowledge about prison policies minimizes women’s abilities to accurately assess their partner’s risk and/ or maximize their denial of risk. The United Nations Development Fund for Women (UNIFEM) and the Joint United Nations Programme on HIV/AIDS collaboratively developed a comprehensive gender and HIV/AIDS web portal to provide up-to-date information on the gender dimensions of the HIV/AIDS epidemic. Their efforts support the need for gender specific approaches toward women in HIV/AIDS prevention and services. Limited HIV/AIDS Prevention programs exist for high-risk sexual behaviors.

This demonstration project heavily weighs on social influences on women and the overall social networks of women to incorporate reproductive health education, communication skills, stigma, condom negotiation, heterosexual risk behaviors, denial of risk, self-esteem and overall wellness and healthy sexual relationships. The proposed project also is in accord with the following Healthy People (HP) 2010 Goal: promote responsible sexual behaviors, strengthen community capacity, and increase access to quality services to prevent sexually transmitted diseases (STDs) and their complications.

Current Grantees:

Projects are in Florida, TX, Alabama, Washington, DC, California, New York and Illinois.

Eligible entities may include not for profit community based organizations, national organizations, colleges and universities, clinics and hospitals, research institutions, state and local government agencies and tribal government and tribal/urban Indian entities and organizations. Faith based and community-based organizations are eligible to apply.

  • The Regents of the University of California San Francisco, San Francisco, CA - state university
  • The Osborne Association, Bronx, New York – non-profit organization targeting ex-offenders
  • Center for Health Justice, Inc., Los Angeles, CA – non-profit, advocacy focus HIV/AIDS
  • Metropolitan Charities, Inc., St. Petersburg, FL – non-profit, neighborhood assistance
  • Calvary Healthcare, Inc., Washington, DC – faith based, multi service
  • AIDS Action Coalition of Huntsville, Huntsville, AL – AIDS services organization
  • Recovery Resource Council, Fort Worth, TX – non-profit focus on alcohol and substance use recovery
  • South Side Help Center, Chicago, IL – non-profit, neighborhood assistance

Evaluation Activities: A multi-site evaluation will begin October, 2010 and continue through October, 2014. A plan or instrument will be developed in consultation with funded sites.

A. Outcome Measures

  • Increase knowledge and knowledge sharing of accurate HIV/STD prevention information among women sexually involved with an incarcerated or recently released incarcerated heterosexual partner.
  • Improve access to HIV health related services for women sexually involved with an incarcerated or recently released incarcerated heterosexual partner.
  • Increase the number of women sexually involved with an incarcerated or recently released incarcerated heterosexual partner voluntarily testing for HIV/STDs.
  • Improve attitudes and receptivity towards condom use and condom negotiation with sexual partners.
  • Increase rates of condom use, thereby reducing current high rates of unplanned pregnancy and STIs.
  • Increase the number of community linkages and networks for ensuring continuum support and resources for women engaged in high-risk heterosexual contact

B. Project Assessment and Evaluation:

  • OWH Orientation for Grantees
  • Site Visit (one during fiscal year; additional visit if deemed necessary)
  • Quarterly and Annual Progress Reports
  • Evaluation Plan
  • Potential Plan for Sustainability
  • Submission of Abstracts/ Draft White Paper highlighting lessons learned, best practices, and next steps
  • Continuous Communication: email, telephone conferencing

Future Prospects:  Continuation of projects in future years is contingent upon the progress and success of the first two years of allocation.

Contact:

Mary L. Bowers
Public Health Advisor
Office on Women's Health
Washington, DC 20201
Phone: (202) 260-0020
Fax: (202) 401-4005
Email: mary.bowers@hhs.gov

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