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83 Fed. Probation 27 (2019)
Gender Differences in a Disease Risk Reduction Intervention for People in Prison-Based Substance Abuse Treatment

handle is hein.journals/fedpro83 and id is 84 raw text is: September 2019 27 Gede DimLJiiffreco in I li llol a Dieae is Reucio ntrvnto fr eol in Pis!on-bse Substance Abuosel:l~l~ Tretmenllt' Wayne E.K. Lehman Texas Christian University Grace A. Rowan New York State Office of Mental Health Jennifer Pankow Texas Christian University George W. Joe Texas Christian University Kevin Knight, Ph.D. Texas Christian University IN 2013, THE CENTER for Disease Control estimated that over 1 million people were living with HIV in the United States and well over 100,000 were unaware of being HIV+. HIV/AIDS was the eighth leading cause of death in the 25-34 age range, and ninth among those 35-44 (Centers for Disease Control, 2016). Although great strides have been made in the prevention and treatment of HIV, it remains a significant problem in certain subpopulations, including rates 3-5 times higher among people in the criminal justice system compared to others in the U.S. (Centers for Disease Control, 2015a; Westergaard, Spaulding, & Flanigan, 2013). Drug use is associated with risky behaviors for HIV through risky sex activities (e.g., sex without a condom and with multiple part- ners) and needle sharing (Centers for Disease 1 Funding for this study was provided by the National Institute on Drug Abuse, National Institutes of Health (NIDA/NIH) through a grant to Texas Christian University (R01DA025885; Wayne E. K. Lehman, Principal Investigator). Interpretations and conclusions in this paper are entirely those of the authors and do not neces- sarily reflect the position of NIDA/NIH or the Department of Health and Human Services. Control, 2015b), and drug use among people in the criminal justice system is as high as 80 percent (James & Glaze, 2006). Furthermore, people in prison who participated in risky activities prior to incarceration often return to those activities after release from prison (Bureau of Justice Statistics, 2001; Braithwate & Arriola, 2003; Seal et al., 2003). Women in Cl Treatment as a Population Release from incarceration back to the com- munity carries a number of high-risk stresses that include reconnecting with family, find- ing housing and employment, healthcare, substance use treatment, and often mental health issues. While return to criminal activ- ity, drug use, and risky sex activities is high in this population, these stresses are especially acute for women. Frequently they have chil- dren to reconnect with and care for; they may be in unhealthy and abusive relationships or may have experienced trauma (Staton-Tindall et al., 2007), and they have reportedly sig- nificantly higher rates of psychiatric illnesses (Grella, Lovinger, & Warda, 2013). In a qualitative study involving incarcerated women and correctional center staff, Martin et al. (2009) reported that five major themes emerged from focus groups and interviews regarding health concerns: 1) addictions and mental health; 2) HIV, hepatitis, and infec- tions; 3) health care while in prison; 4) life skills for reentry to the community; and 5) relationships with family, children, and others. Janssen et al. (2017) found that suc- cessful reintegration into the community after incarceration for women was supported by health-related strategies, including health assessments at admission, treatment for men- tal health issues, and treatment for chronic medical problems. In part because of critical factors and needs specific to incarcerated females in substance abuse treatment, gender- responsive treatments have been implemented (e.g., Covington & Bloom, 2006) that are designed to specifically address pathways and factors unique to incarcerated women, and data have shown such programs to be effective for women (e.g., Messina et al., 2010). The Centers for Disease Control and Prevention estimated that 19 percent of the almost 40,000 new HIV diagnoses in the U.S in 2017 were adult and adolescent women

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