REDUCING AIDS AND RELAPSE

Among the most serious social ills facing urban communities are the overlapping problems of AIDS, drug use, and criminal behavior. Some evidence indicates that this complex of problems is increasing more rapidly among women. AIDS and drug dependency are the two leading causes of death in New York City among women of ages 25-34. Drug related crimes are often higher among women offenders than among their male counterparts. There is a critical need to develop testable strategies designed for female drug- using offenders, particularly in areas with high rates of HIV infection. Such interventions should facilitate the transition from prison to community, reduce recidivism and addiction relapse, and reduce the spread of AIDS among this population. This study will test the efficacy of a group intervention designed to meet these objectives. The study is sited in Rikers Island Correctional Facility in New York City, and follows female offenders as they return to the community. The study will include two phases: 1) development--including focus groups and semi- structured interviews with offenders, prison staff and administrators; and pilot work; 2) an intervention trial--beginning with a pretest of 540 female inmates, and subsequent random assignment of 486 residents inmates to either a skills-building condition or an information/attention control condition. Participants in the skills-building condition will be enrolled in a 16 session series of group sessions, and later continue with 12 monthly booster sessions post-release. Controls will receive two sessions of AIDS information in the correctional facility. Study participants will be assessed twice within the correctional setting, and measured three times annually for a total of 7 measurement occasions. Outcome variables will include indicators urine screening for the presence of chemical substances; sexual behavior, including use of condoms; drug related risk-taking, including use of needles and shared drug paraphernalia; interpersonal skill; social support; self-efficacy; help-seeking contact with treatment agents and other supportive services; and indicators of criminal activity. Covariates of interest include mental health status, appraisal of HIV risk, and self-reported health indicators. The research is a collaborative effort of Columbia University School of Social Work, John Jay College of Criminal Justice, Montefiore Medical Center-Rikers Island, and the New York City Department of Correctional Services.