Feasibility of an HIV/STI Risk-Reduction Program for Incarcerated Women Who Have Experienced Interpersonal Violence

Abstract

HIV and other sexually transmitted infections (STIs) and interpersonal violence (IV; e.g., childhood abuse, partner violence, and rape) victimization are significant and interconnected public health problems facing incarcerated women. We adapted a best-evidence HIV-prevention intervention for women (the Women’s CoOp) to address sexual safety among incarcerated women with histories of interpersonal violence victimization. The standard Women’s CoOp teaches safe sex, substance use harm reduction, and violence prevention information and skills needed to empower women to make more intentional decisions about their safety. We also incorporated strategies to increase affect management, social support, and access to community resources. This resulted in the first trauma-focused HIV-prevention intervention for women that directly addresses the sequelae of IV (such as affect dysregulation in sexual situations) within the context of HIV harm reduction. This manuscript describes the rationale, feasibility, acceptability, and pre–post outcomes of this intervention among 14 women nearing release from prison in two state prison systems. Assessments took place at baseline, prior to release, and at 2-, 5-, and 8 months after release. The intervention overall and each of its components were feasible and acceptable. Participants’ number of unprotected sexual occasions, post-traumatic stress disorder symptoms, and depressive symptoms decreased significantly from baseline to post-release. Effectiveness in obtaining resources increased significantly from baseline to post-release. Because pre–post measurements of outcomes are confounded with incarceration and subsequent release in this preliminary study, a randomized controlled trial is needed to establish the efficacy of this tailored intervention.