Tito: An Education and Empowerment Based HIV Prevention Intervention for People Leaving Jail

Background and Purpose: Jails are a key intervention point for HIV prevention. Jails also present unique challenges. Teach Inside Teach Outside (TITO) is a group based education and empowerment HIV prevention intervention that begins inside jail and continues in community settings. We hypothesize that TITO would be more effective encouraging follow up with the intervention after jail release than currently accepted prevention interventions that are based on counseling. Methods: 600 Participants in a city jail were randomized to TITO or an individual counseling-based HIV safety and prevention intervention. Data were collected by face to face interviews starting while jail, and until 6 months after release. Also included is an intensive ethnographic study of TITO and the participants’ experiences of jail detention and jail release. Results: Among 249 participants engaged after release from jail,103 completed their respective programs. Among the 599 who were followed in the study, those in the control condition were twice as likely to be engaged in the programs after release, and were also twice as likely to complete the program, when compared with the experimental TITO conditions. This low probability result (p < .01) was counter to the hypothesis. Ethnographic data suggest that the boundaries between the two intervention are blurred upon graduation as TITO clients sought instrumental supports of the IPSI (control) condition. Conclusions and Implications: Further dialogue between the RCT results and ethnographic results may shed light on interactions between this intervention model and specific social, economic, and health related characteristics of participants.