Training formerly incarcerated women as health promoters: An underutilized HIV/STI prevention model

The public health community has focused on incarceration as an opportunity for the delivery of HIV and STI prevention and treatment inside the correctional system. Very few efforts have targeted the 80% of women involved in the criminal justice system who have re-entered the community on parole or probation. The majority of these women are arrested for non-violent offenses related to their drug use or involvement with drug using partners. Sisters Reaching Out, a community-based program developed by the Chicago Women's AIDS Project, trains formerly incarcerated women as HIV/STI health promoters while providing three months of case management and supportive services. A qualitative and quantitative outcome evaluation was conducted with the first three program cycles composed of 19 African-American women. Evaluation methods included a behavioral survey conducted pre- and post intervention and at six months. Focus groups were conducted with a convenience sample of participants. Initial findings indicate high program retention and program satisfaction, increased condom use with casual and exchange partners, and increased discussion of HIV risk with peer networks. Key qualitative findings highlight the importance of trust to achieving high completion rates and the barrier that lack of employment poses to the recovery process. The authors conclude that training formerly incarcerated women as health promoters and harm reduction advocates is an underutilized HIV prevention intervention that has the potential to decrease risk behaviors and improve health outcomes for both the program participants and their broader social network.