Efficacy of an Adapted HIV and Sexually Transmitted Infection Prevention Intervention for Incarcerated Women: A Randomized Controlled Trial

Authors:
  • JCJamie L. Crandell
    Jamie L. Crandell
  • ANA. M. Neevel
    A. M. Neevel
  • SPSharon D. Parker
    Sharon D. Parker
  • MCMonique Carry
    Monique Carry
  • BWBecky L. White
    Becky L. White
  • AFAmy M. Fasula
    Amy M. Fasula
  • JHJeffrey H. Herbst
    Jeffrey H. Herbst
  • DGDeborah J. Gelaude
    Deborah J. Gelaude
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Abstract
Objectives. We tested the efficacy of an adapted evidence-based HIV–sexually transmitted infection (STI) behavioral intervention (Providing Opportunities for Women’s Empowerment, Risk-Reduction, and Relationships, or POWER) among incarcerated women. Methods. We conducted a randomized trial with 521 women aged 18 to 60 years in 2 correctional facilities in North Carolina in 2010 and 2011. Intervention participants attended 8 POWER sessions; control participants received a single standard-of-care STI prevention session. We followed up at 3 and 6 months after release. We examined intervention efficacy with mixed-effects models. Results. POWER participants reported fewer male sexual partners than did control participants at 3 months, although this finding did not reach statistical significance; at 6 months they reported significantly less vaginal intercourse without a condom outside of a monogamous relationship and more condom use with a main male partner. POWER participants also reported significantly fewer condom barriers, and greater HIV knowledge, health-protective communication, and tangible social support. The intervention had no significant effects on incident STIs. Conclusions. POWER is a behavioral intervention with potential to reduce risk of acquiring or transmitting HIV and STIs among incarcerated women returning to their communities.

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