HIV Interventions With Probationers: A Promising Model and Some Caveats for Effective Interventions

Steven S. Martin, University of Delaware
Hilary L. Surratt, University of Delaware
James A. Inciardi, University of Delaware
Daniel J. O'Connell, University of Delaware
Erik Faust Dietz, University of Delaware
Lisa M. Gilman, University of Delaware
Clifford A. Butzin, University of Delaware

Earlier work by our group found that probationers in Delaware have levels of injection drug use, other serious drug use, and rates of risky sexual behaviors and combinations of both drug and sexual risk behaviors that approach those we have observed in prison populations. Since probationers have more opportunities to engage in risk behaviors than do prisoners, the importance of HIV interventions with probationers becomes readily apparent. In this paper we examine a sample of 500 probationers representative of the supervised probationer population in Delaware. The sample respondents receive a baseline interview, then they are randomly selected to receive either the NIDA standard HIV intervention or a focused intervention based on a cognitive thought-mapping model. Intervention boosters are offered at two follow-up intervals in the following 3 months, and participants are reinterviewed at 6 months. In this paper, we first examine the interventions' effectiveness in changing attitudes and behaviors at the 6 month interview. The data support the conclusion that the focused intervention produces more risk reduction than the NIDA standard. Then, we examine putative predictors that may specify or interpret the intervention effects, using a series of stepwise OLS and logistic regression models including several additive and interactive covariates. Discussion centers on examining the correlates that seem to specify the impact of the interventions and the need to consider such factors in selecting the appropriate interventions for probationers.

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Updated 05/20/2006