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Project SPARC designed and implemented an evidence-based integrated substance abuse, HIV/AIDS, and hepatitis prevention curriculum to people involved in the criminal justice system for drug-related crimes to increase HIV/AIDS and hepatitis knowledge among high-risk individuals.
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Project SPARCSubstance Abuse/HIV/HepatitisPrevention forAdultsReentering the Community Community Pediatrics
Teshina MattsonApril BiasiolliDrew Russell
Nancy Amodei, PhDAnthony Scott, PhD
Irene Chedjieu
Key Ideas• Substance abuse, HIV/AIDS,
and hepatitis are interrelated. • San Antonio has unique needs
related to these diseases.
• Educational activities emphasize participation and encourage learning.
• Project SPARC curriculum improves HIV and hepatitis knowledge.
HIV/AIDS and Hepatitis• Complicate each other’s treatment
• CDC recommended addressing together
• Associated with: Incarceration Drug use Risky Sex Sex
work
Bexar County: San Antonio• TX ranks 4th in nation for HIV
prevalence (CDC, 2008)
• 7% of total PLWHA in SA; 6% diagnosed in TDCJ (TX-DSHS, 2008)
• HCV affects 1.79% of TX population (Yalamanchili, 2005); 27-48% of incarcerated (Baillargeon, 2003)
• Minorities disproportionately effected
PopulationMinority adults involved in criminal justice system for
drug-related crimes
InterventionIntegrated substance abuse, HIV,
and hepatitis education
– Drug Court: 5 x 2-hour– Treatment: 1 x 2-hour
– Bexar County Drug Court– In-patient treatment
Social-Cognitive Theory
Drug Court Participants & Sexual Partners– N=230– Mean age: 33.75 (range 17-61)– 52% male– 56% white; 22% black; 21.3% other– 57% Hispanic (N=131)
In-patient Treatment Participants– N=138– Mean age: 30 (range 19-63)– 87% male– 61% white; 17% black; 25% other– 70% Hispanic (N=97)
Demographics
Educational Tools
• Scientific & colloquial terms
• Role-playing
• Movies
• Metaphors
• Jokes
• Discussions
• Interactive activities
• Risk reduction reasoning
Body Openings Activity
• Rank these body openings for effectiveness in HIV transmission: – Vein– Anus– Vagina– Meatus– Mouth
• Teaches vocabulary• Gets participants
involved• Think about HIV in a
new way: “If you were HIV, how would you want to get into the body?”
Condom Demonstration• Hands on
• Helps with anxieties
• Practice/learn important steps
• Creates a light-hearted atmosphere
Condom Demonstration
Condom Cons and Comebacks• “It doesn’t feel as good.”
– Use lube – inside and out!– Try out different types
• “I don’t want to ruin the moment.”– Keep condoms handy.– Practice – Make it part of foreplay
• “I’m embarrassed to talk about it.”– Role-play or practice mentally– Use non-verbal communication– Be positive: “I want use to both feel safe and
relaxed.” • “My partner will think I’m ‘dirty’ or cheating.”
– Listen and acknowledge feelings– STIs are common & often asymptomatic
Assessment• 10-item true-false knowledge assessment
– “Birth control pills protect women from getting HIV/AIDS.”– “Only people who look sick can spread the HIV/AIDS virus.”– “There is no cure for AIDS.”– “Hepatitis is a disease that causes inflammation of the liver.” – “Everyone who has the hepatitis C virus develops symptoms.”
• Score 0-100
Results
– Overall: t[308]=9.45, p<.001
– Drug court: t[187]=9.24, p<.001
– Treatment: t[120]=4.1, p<.001
Conclusions• SPARC curriculum
improves HIV and hepatitis knowledge
• Both full and brief curricula effective
Implications • Contributes to prevention outcomes &
knowledge regarding effective programs for minorities involved in criminal justice system
• There is a need and eagerness to learn from this population
AcknowledgementsSPARC Team
Delma Johnson, Surveyor
Candi Pieper & Gloria Perez, Administrative Support
Bexar County Drug Court Team
Judge Alfonso Alonso
Judge Ernie Glenn
Roberto Ruiz & Diana Zamarron,
DC Coordinators
ProvidersAlamo Medical Research
San Antonio AIDS Foundation & Hope Action Care
THANK YOU
Questions?
Community Pediatrics Presenters
Teshina MattsonApril BiasiolliDrew Russell