An Exploratory Study of Mental Health & HIV Risk Behavior among Drug-Using Rural Women in Jail

Objective

Rural women, particularly those involved in the criminal justice system, are at risk for HIV due to the increasing prevalence of injection drug use, as well as limited services. Research on HIV risk correlates, including drug use and mental health, has primarily focused on urban women incarcerated in prisons. The purpose of this exploratory study is to examine dual HIV risk behavior by three different mental health problems (depression, anxiety, and PTSD) among drug-using women in rural jails.

Methods

This study involved random selection, screening, and face-to-face interviews with 136 women from rural jails in one Appalachian state. Analyses focused on the relationship between mental health and HIV risk among this sample of drug-using women.

Findings

Nearly 80% of women self-reported symptoms of depression, and more than 60% endorsed symptoms consistent with anxiety and PTSD symptoms. Mental health was significantly correlated with severity of certain types of drug use, as well as risky sexual activity. In addition, for women experiencing anxiety and PTSD, injection drug use moderated the relationship between mental health and risky sexual activity.

Implications

Based on these rates of drug use, mental health problems, and the emergence of injection drug use in rural Appalachia, the need to explore the relationships between these issues among vulnerable and understudied populations, such as rural women, is critical. Due to service limitations in rural communities, criminal justice venues such as jails provide opportune settings for screening, assessment, and intervention for drug use, mental health, and HIV education and prevention.

Table 1

Sample profile of mental health, substance use, and HIV risk behavior (N=136)

Demographics	Mean or Percent
Age	31.3
White	98.5%
Years of Education	11.2
Married	39.7%
Employed in 6 mo. before Incarceration	29.4%
Days Incarcerated (current sentence)	76.5
Number of times incarcerated as an adult	6.3
Mental Health1
Anxiety	61.8%
Depression	77.2%
Post-Traumatic Stress	62.5%
Endorses symptoms for two mental health problems	23.5%
Endorses symptoms for all three mental health problems	47.1%
Substance use (average # days in past 6 months)
Oxycodone	78.8
Anti-anxiety medication	71.6
Buprenorphine	53.9
Marijuana	57.2
Lortab/Hydrocodone	43.6
Percocet	33.8
Methamphetamine	32.8
Alcohol	18.3
Methadone	16.2
Downers/sleeping pills	10.7
Used multiple drugs in past 6 mo.	80.9%
Mean # of days in past 6 mo. used multiple drugs	108.6
# of days in 6 mo. prior was high on drugs	135.3
HIV Risk Behavior
Ever injected a drug in lifetime	75.7%
Injected drug in past 6 months	62.5%
Shared needles in past year (n=59)	70.3%
Shared works in the past year (n=59)	96.6%
Average number of lifetime male sex partners	24.4 (range 2-250)
Average number of sex partner in past year	3.6 (range 0-100)
Ever traded sex for money/drugs/food	53 (39.0%)
Any past year exchange of sex for drugs or money	31 (22.8%)

1Note: Mental health issues based on meeting GAIN criteria.

Full article at:   http://goo.gl/2WMeEv

By:   Michele Staton-Tindall, Kathi LH Harp, Alexandra Minieri, Carrie Oser, J. Matthew Webster, Jennifer Havens, and Carl Leukefeld

 

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