Journal of Health Care for the Poor and Underserved

Journal of Health Care for the Poor and Underserved
Volume 16, Number 4 Supplement B, November 2005
National Institute on Drug Abuse (NIDA)
National Institute of Health (NIH)
Reducing HIV/AIDS and Criminal Justice Involvement in African Americans as a Consequence of Drug Abuse

CONTENTS

    Beatty, Lula A.
    Jones, Dionne J.
    Doctor, LeKhessa.
  • Introduction: Reading HIV/AIDS and Criminal Justice Involvement in African Americans as a Consequence of Drug Abuse
    [Access article in HTML] [Access article in PDF]
    Subject Headings:
    • HIV infections -- United States -- Prevention.
    • AIDS (Disease) -- United States -- Prevention.
    • African Americans -- Drug use.
    • Criminal justice, Administration of -- United States.

Heroes and Great Ideas

    Primm, Annelle B.
    Brown, Lawrence S.
  • Beny J. Primm, MD: Pioneer Physician, Educator, and Advocate for People with Addictions and HIV/AIDS
    [Access article in HTML] [Access article in PDF]
    Subject Headings:
    • Primm, Beny J.
    • Drug abuse -- Treatment -- United States.
    • HIV infections -- United States -- Prevention.
    • AIDS (Disease) -- United States -- Prevention.
    • Physicians -- United States -- Biography.

Part I: HIV/AIDS, Drug Abuse and Prevention

    Wyatt, Gail Elizabeth.
    Carmona, Jennifer Vargas.
    Loeb, Tamra Burns.
    Williams, John K.
  • HIV-Positive Black Women with Histories of Childhood Sexual Abuse: Patterns of Substance Use and Barriers to Health Care
    [Access article in HTML] [Access article in PDF]
    Subject Headings:
    • African American HIV-positive women -- Medical care.
    • Child sexual abuse -- United States -- Psychological aspects.
    • Psychic trauma in children -- United States.
    • African American women -- Drug use.
    Abstract:
      A constellation of factors contributes to Black women's health including stressors and traumatic experiences. Their psychological adjustment and substance use can further affect their health status. The purpose of this study was to examine patterns of substance abuse and barriers to health care among HIV-positive Black women with histories of childhood sexual abuse (CSA). Baseline data on a community sample of 75 Black HIV-positive women were analyzed to assess and identify drug use, alcohol use, participation in an alcohol or drug treatment program, and communication skills with providers, all of which may act as barriers to health care. Findings indicate that substance use is a significant health problem, with 83% of the participants having used at least one substance regularly and 28% having engaged in regular injection drug use. Barriers to health care included confidentiality issues, poor financial resources, difficulty getting an appointment, excessive waiting to see a health care provider and obligation to care for others. Contrary to past research, poor communication between the participants and the providers did not seem to be a barrier to health care utilization for these women. Early traumatic experiences, including CSA, regardless of whether incidents involved penetration, may exacerbate the problems faced by HIV-positive Black women. Implications for future research and culturally relevant prevention and intervention programs are discussed.
    Keywords:
      Black women, trauma, HIV serostatus, drug use
    Stroman, Carolyn A.
  • Disseminating HIV/AIDS Information to African Americans
    [Access article in HTML] [Access article in PDF]
    Subject Headings:
    • HIV infections -- United States -- Prevention.
    • AIDS (Disease) -- United States -- Prevention.
    • Communication in medicine -- United States.
    • African Americans -- Services for.
    Abstract:
      Prior research indicates that HIV/AIDS communication must be viewed as a key component of the implementation of a comprehensive HIV/AIDS prevention program. In view of the radical increase in HIV/AIDS in the African American community, tailoring health messages on prevention strategies to African Americans becomes particularly important. This paper focuses on health communication to African Americans as an integral part of contemporary HIV/AIDS interventions.
    Corneille, Maya A.
    Ashcroft, Amie M.
    Belgrave, Faye Z.
  • What's Culture Got to Do with It? Prevention Programs for African American Adolescent Girls
    [Access article in HTML] [Access article in PDF]
    Subject Headings:
    • Substance abuse -- United States -- Prevention.
    • African American girls -- Psychology.
    • Health behavior in adolescence -- United States.
    • Behavior modification -- Social aspects -- United States.
    Abstract:
      This paper examines prevention programming for African American girls by placing the prevention process within the larger African and African American cultural context. We provide an overview of the theories and issues we consider most relevant to African American culture, including Africentric theory, ethnic identity, gender identity and relational theory, developmental issues, the community context, and historical considerations. Drawing from our own drug prevention work, we provide examples of how to incorporate culture into prevention programs to make them most relevant for the target population. We also summarize our own efforts to create culturally appropriate prevention interventions and their impact on the girls in our programs. We conclude with suggested directions for future research into culture-specific prevention programs.
    Keywords:
      African American girls, culture, cultural competence, prevention programs

Part II: The Criminal Justice System and Drug Abuse

    Iguchi, M. Y. (Martin Y.)
    Bell, James, 1943-
    Ramchand, Rajeev N.
    Fain, Terry.
  • How Criminal System Racial Disparities May Translate into Health Disparities
    [Access article in HTML] [Access article in PDF]
    Subject Headings:
    • Criminal justice, Administration of -- United States.
    • Drug abuse and crime -- United States.
    • Discrimination in justice administration -- United States.
    • African American criminals -- Social conditions.
    • Health and race -- Social aspects -- United States.
    Abstract:
      Disadvantaged racial and ethnic minorities in the U.S. are strikingly over-represented in the juvenile justice and adult criminal justice systems. This paper briefly reviews the extent of over-representation attributable primarily to drug offenses and an earlier conceptual framework introduced by Iguchi and colleagues showing how the use of incarceration as a key drug control tool has disproportionately affected the health and well being of racial and ethnic minority communities. We then provide observations from the field that demonstrate how the implementation of a quality assessment approach might be used to mitigate procedural/structural biases that contribute to disparities in minority confinement, and ultimately, to reduce disparities in access to resources and health care.
    Keywords:
      Disproportionate minority confinement, juvenile justice, drug offenders, prison admissions, drug abuse, health disparities, drug policy, quality assessment.
    Taxman, Faye S.
    Byrne, James M.
  • Racial Disparity and the Legitimacy of the Criminal Justice System: Exploring Consequences for Deterrence
    [Access article in HTML] [Access article in PDF]
    Subject Headings:
    • Punishment in crime deterrence -- Social aspects -- United States.
    • Criminal justice, Administration of -- United States.
    • Discrimination in justice administration -- United States.
    • Minorities -- Legal status, laws, etc. -- United States.
    Abstract:
      Minority (over) representation in the criminal justice system remains a puzzle, both from a policy and an intervention perspective. Cross-sectional reviews of the policies and practices of the criminal justice system often find differential rates of involvement in the criminal justice system that are associated with the nature of the criminal charge/act or characteristics of the offender; however, longitudinal reviews of the race effect often show it to be confounded by procedural and extralegal variables. This review focuses on how the cumulative policies and practices of the criminal justice system contribute to churning, or the recycling of individuals through the system. In conducting our review, we describe how the same criminal justice processes and practices adversely affect select communities. The consequences of policies and procedures that contribute to churning may affect the legitimacy of the criminal justice system as a deterrent to criminal behavior. A research agenda on issues related to legitimacy of the criminal justice system aimed at a better understanding of how this affects individual and community behavior is presented.
    Keywords:
      Racial minority, ethnic minority, criminal justice system, legitimacy, procedural justice.
    Griffin, James P.
  • The Building Resiliency and Vocational Excellence (BRAVE) Program: A Violence-Prevention and Role Model Program for Young, African American Males
    [Access article in HTML] [Access article in PDF]
    Subject Headings:
    • Violence -- United States -- Prevention.
    • Substance abuse -- United States -- Prevention.
    • Resilience (Personality trait) in adolescence.
    • African American young men.
    Abstract:
      There are sharp disparities between non-Hispanic Whites and African Americans in mortality and years of potential life lost for numerous health-related conditions, including HIV/AIDS. The Building Resiliency and Vocational Excellence (BRAVE) Program is an intervention using Resiliency Networking designed for use with African American young men to help offset these disparities. Resiliency Networking incorporates coaching, career planning, and re-definition of gender roles to help young men develop a sense of purpose and future and to manage their lifestyles effectively. In addition to fostering a strong link with an older mentor, the program fosters healthy peer-to-peer relationships. The paper reports on preliminary use of the intervention and recommends future applications.
    Keywords:
      African American, youth, men, mentoring, Resiliency Networking.

Part III: The Intersection of HIV/AIDS and the Criminal Justice System

    Sterk, Claire E., 1957-
    Theall, Katherine.
    Elifson, Kirk W., 1943-
  • African American Female Drug Users and HIV Risk Reduction Challenges with Criminal Involvement
    [Access article in HTML] [Access article in PDF]
    Subject Headings:
    • HIV infections -- United States.
    • African American women -- Drug use.
    • Criminal justice, Administration of -- United States.
    Abstract:
      The main objectives of this paper are to examine the prevalence of criminal involvement among a sample of African American female drug users and to identify factors associated with that criminal involvement, where criminal involvement is defined as having been in jail or prison. Data were collected in Atlanta from 333 adult women at two points in time, namely during baseline assessments conducted prior to their enrollment in an HIV risk reduction intervention and at follow-up assessments conducted 6 months after completion of the intervention. The prevalence and period prevalence of criminal involvement were relatively high. At baseline, 86.8% of the women indicated criminal involvement at some point in their lives and over one-third (37.2%) were involved in the year prior to enrolling into the study. During follow-up interviews, 31.5% reported criminal involvement during the 6 months since enrollment. The findings revealed that victimization/abuse and drug use setting might be salient risk factors for criminal involvement. The unique needs of women such as those in this sample must be taken into account when designing intervention and prevention programs, both within and outside the criminal justice system.
    Keywords:
      Criminal justice, women, HIV, drug use.
    Belenko, Steven R.
    Shedlin, Michele.
    Chaple, Michael.
  • HIV Risk Behaviors, Knowledge, and Prevention Service Experiences Among African American and Other Offenders
    [Access article in HTML] [Access article in PDF]
    Subject Headings:
    • HIV infections -- New York (State) -- New York -- Prevention.
    • Risk-taking (Psychology) -- New York (State) -- New York.
    • African American prisoners -- Services for -- New York (State) -- New York.
    • Sexually transmitted diseases -- Study and teaching -- New York (State) -- New York.
    Abstract:
      African Americans are at the intersection of the AIDS epidemic and burgeoning prison and offender populations, yet little is known about offenders' HIV knowledge and risk behaviors or ability to access effective services. We present findings from an exploratory study based on 300 interviews with New York City offenders conducted in 2001–2002. The data indicate relatively high rates of HIV infection and HIV risk behaviors among African American and other offenders. There were no clear patterns of risk behaviors by race/ethnicity. Although overall HIV knowledge level is high, important gaps in HIV knowledge remain and there is widespread skepticism among offenders about government information about HIV/AIDS. In the corrections setting, there is inconsistent access to HIV prevention and education services, and an emphasis on more passive learning materials. To reduce HIV infection rates, there is a need to expand peer-led and culturally- and gender-specific interventions, and to improve access to correctional facilities for community-based HIV service providers. HIV interventions must also be expanded for offenders on probation and parole. Mandatory HIV education and harm reduction approaches should be considered.
    Keywords:
      African American, HIV/AIDS, correctional systems, drug abuse, HIV prevention, HIV service delivery.
    Braithwaite, Ronald L., 1945-
    Stephens, Torrance T.
    Treadwell, Henrie M.
    Braithwaite, Kisha.
    Conerly, Rhonda.
  • Short-term Impact of an HIV Risk Reduction Intervention for Soon-to-be Released Inmates in Georgia
    [Access article in HTML] [Access article in PDF]
    Subject Headings:
    • HIV infections -- Georgia -- Prevention.
    • Risk-taking (Psychology) -- Georgia.
    • African American prisoners -- Georgia.
    • Sexually transmitted diseases -- Georgia.
    Abstract:
      The purpose of this study was to determine the impact of an intervention seeking to reduce risk for HIV/AIDS infection among a sample of soon-to-be-released adult male inmates. This analysis is based on a random sample of 116 adult male prisoners recruited and interviewed prior to their participation in an HIV/AIDS and recidivism risk reduction intervention and again three months after they were reintegrated into the community. The intervention program was designed to reduce risky sexual behaviors and alcohol, tobacco, and other drug-related behaviors. It had a randomized, Latin-square design to evaluate adult male offenders across four conditions. Findings indicate that the intervention for the inmate population was effective in reducing sexual self-expectation and substance use and increasing condom use self-efficacy over a three-month period.
    Keywords:
      HIV/AIDS prevention, incarcerated adult males, substance use, risky sexual behaviors.
    Blankenship, Kim M.
    Smoyer, Amy B.
    Bray, Sarah J.
    Mattocks, Kristin.
  • Black-White Disparities in HIV/AIDS: The Role of Drug Policy and the Corrections System
    [Access article in HTML] [Access article in PDF]
    Subject Headings:
    • HIV infections -- United States -- Prevention.
    • AIDS (Disease) -- United States -- Prevention.
    • Drug control -- United States.
    • Discrimination in justice administration -- United States.
    Abstract:
      African Americans in the United States are disproportionately affected by HIV/AIDS. We focus in this paper on the structural and contextual sources of HIV/AIDS risk, and suggest that among the most important of these sources are drug policy and the corrections system. In particular, high rates of exposure to the corrections system (including incarceration, probation, and parole) spurred in large part by federal and state governments' self-styled war on drugs in the United States, have disproportionately affected African Americans. We review a wide range of research literature to suggest how exposure to the corrections system may affect the HIV/AIDS related risks of drug users in general, and the disproportionate HIV risk faced by African Americans in particular. We then discuss the implications of the information reviewed for structural interventions to address African American HIV-related risk. Future research must further our understanding of the relations among drug policy, corrections, and race-based disparities in HIV/AIDS.
    Keywords:
      HIV/AIDS, race disparities, structural interventions, drug use, drug policy, criminal justice, corrections, probation, parole, incarceration.

Reviews

    Fauchald, Sally K.
  • Workable Sisterhood: The Political Journey of Stigmatized Women with HIV/AIDS (review)
    [Access article in HTML] [Access article in PDF]
    Subject Headings:
    • Berger, Michele Tracy. Workable sisterhood: the political journey of stigmatized women with HIV/AIDS.
    • Women with social disabilities -- United States -- Political activity.
    Roberts, Kimyona.
  • The Secret Epidemic: The Story of AIDS and Black America (review)
    [Access article in HTML] [Access article in PDF]
    Subject Headings:
    • Levenson, Jacob. Secret epidemic: the story of AIDS and Black America.
    • AIDS (Disease) -- United States.



[Project MUSE] [Search Page] [Journals] [Journal Directory] [Top]