title: An ecosystem-based intervention to reduce HIV transmission risk and increase medication adherence among inmates being released to the community.
abstract: HIV+ inmates reentering their communities are at increased risk for poor health outcomes and for transmitting HIV. This article reports on a randomized trial comparing an ecosystem-based intervention and an individually focused intervention for reducing HIV transmission risk and improving medication adherence. Reincarceration was considered as a secondary variable. Both groups decreased sexual risk behavior over the 12-month follow-up period. Unexpectedly, the ecosystem intervention group was less likely to be taking medication or to be adherent and more likely to have been reincarcerated. Failure to demonstrate a significant advantage of the ecosystem intervention may have resulted from the difficulty of engaging family and other ecosystem members in the intervention. Implications for developing and applying interventions for this population are discussed.
authors: Department of Medicine, Center for AIDS Prevention Studies, University of California San Francisco, CA, USA.
authors: Olga Grinstead
authors: OG
authors: Reznick
authors: Kathleen
authors: K
authors: McCartney
authors: Steven E
authors: SE
authors: Gregorich
authors: Barry
authors: B
authors: Zack
authors: Daniel J
authors: DJ
authors: Feaster
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D002140:California; D003710:Demography; D017753:Ecosystem; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000635:transmission*; D006801:Humans; D007407:Interviews as Topic; D016015:Logistic Models; D008297:Male; D055118:Medication Adherence; D011329:Prisoners; D012309:Risk-Taking
keywords: HIV; adherence; inmates; intervention; reentry
references: AIDS Behav. 2011 Feb;15(2):356-64
references: 21042930
references: J Acquir Immune Defic Syndr. 2006 Dec 1;43 Suppl 1:S69-78
references: 17133206
references: Am J Public Health. 2006 Oct;96(10):1854-61
references: 17008583
references: J Urban Health. 2001 Jun;78(2):214-35
references: 11419576
references: J Fam Psychol. 2010 Feb;24(1):51-9
references: 20175608
references: Drug Alcohol Depend. 2010 Oct 1;111(3):227-34
references: 20538417
references: Antivir Ther. 2004 Oct;9(5):713-9
references: 15535408
references: AIDS Educ Prev. 2008 Aug;20(4):285-300
references: 18673062
references: Am J Epidemiol. 2007 Jul 15;166(2):219-27
references: 17478436
references: AIDS Educ Prev. 1996 Feb;8(1):58-71
references: 8703641
references: AIDS Care. 2006 May;18(4):290-301
references: 16809106
references: AIDS Behav. 2010 Aug;14(4):731-47
references: 19020970
references: Am J Public Health. 2005 Oct;95(10):1682-4
references: 16186447
references: J Health Soc Behav. 2008 Mar;49(1):56-71
references: 18418985
references: J Infect Dis. 2005 Feb 1;191(3):339-47
references: 15633092
references: Fam Process. 2010 Jun;49(2):204-19
references: 20594207
references: Am J Public Health. 2005 Oct;95(10):1701-6
references: 16131637
references: J Fam Psychol. 2010 Dec;24(6):746-55
references: 21171773
references: AIDS Care. 2000 Jun;12(3):255-66
references: 10928201
references: J Consult Clin Psychol. 2004 Apr;72(2):288-303
references: 15065962
references: Am J Epidemiol. 2006 Feb 15;163(4):310-5
references: 16371516
references: J Urban Health. 2006 May;83(3):372-81
references: 16739041
references: J Health Care Poor Underserved. 2005 Nov;16(4 Suppl B):130-9
references: 16327112
references: Postgrad Med J. 2003 Jan;79(927):36-42
references: 12566550
references: Clin Child Fam Psychol Rev. 2000 Jun;3(2):117-34
references: 11227062
references: J Urban Health. 2010 Dec;87(6):954-68
references: 21046470
references: J Urban Health. 2005 Mar;82(1):162-70
references: 15738327
references: AIDS. 2007 Feb 19;21(4):501-7
references: 17301569
references: J Fam Psychol. 2008 Feb;22(1):51-61
references: 18266532
references: Behav Sci Law. 2005;23(5):689-707
references: 16170791
references: AIDS Patient Care STDS. 2003 Dec;17(12):645-56
references: 14746658
references: Gerontologist. 2003 Aug;43(4):521-31
references: 12937331
references: AIDS Educ Prev. 2001 Apr;13(2):109-19
references: 11398956
references: Public Health Rep. 2010 Jan-Feb;125 Suppl 1:64-71
references: 20408389
references: AIDS Educ Prev. 2009 Dec;21(6):552-69
references: 20030499
references: Am J Community Psychol. 2010 Dec;46(3-4):361-75
references: 20865315
references: AIDS. 2003 Nov 7;17(16):2345-9
references: 14571186
references: J Urban Health. 2006 May;83(3):339-48
references: 16739034
references: Public Health Rep. 2005 Jan-Feb;120(1):84-8
references: 15736336
references: AIDS Behav. 2011 Feb;15(2):365-75
references: 20703795