Multidimensionality Matters: An Effective HIV, Hepatitis C, and Substance-Use Prevention Program for Minority Parolees

Abstract

African Americans and Hispanics are more likely than Whites to be incarcerated, and are also disparately affected by HIV, hepatitis C, and substance use. Reaching these populations as they leave prison is important given high rates of substance use and sexual risk-taking behaviors among U.S. prisoners. A 12-session, culturally appropriate, evidence-based, small-group intervention was administered successfully with minority parolees. Participants experienced lasting improvements in HIV and hepatitis C knowledge, condom use, and resource knowledge after participating in the Holistic Health Recovery Program. Collaborative service providers and program multidimensionality are credited for the program's success, high retention rate, and positive reception.

KEYWORDS:

• hepatitis C
• HIV
• minority
• parole
• prevention
• substance use

Acknowledgments

Johnna Fandel is now at Community Wise, San Francisco, California, USA.

This research was funded by the Substance Abuse and Mental Health Services Administration (SAMHSA) Minority HIV/AIDS Initiative, Grant 5U79SP013416-05.

Notes

Note. LL = lower limit of 95% confidence interval of the mean difference; UL = upper limit of 95% confidence interval of the mean difference.

Note. Different superscripts indicate a statistically significant difference of p < .05 for change over time.

^a N = 208, R2 = .046. ^b Female = 0, Male = 1. ^c Non-Hispanic Black = 0, Hispanic = 1. ^d  N = 166, R2 = .085.

*p < .05. **p < .01. ***p < .001.

Substance use behavioral measures were collected, but because all of the participants were under case management and use would be a violation of their parole, analyses of the substance use measures are not included in this study due to validity concerns.

Protection during anal sex was also assessed, but the sample size was too small to analyze.

Criteria included: current TASC client, racial/ethnic minority, under case management, and not in treatment.

The first five groups met weekly for 12 weeks.