Dickson Megan F, Pike Erika, Staton Michele
University of Kentucky.
J Appalach Health. 2025 Jan 29;6(4):81-96. doi: 10.13023/jah.0604.07. eCollection 2025.
Rural Appalachian women who use drugs and are involved in the criminal legal system are at increased risk for health consequences (such as HIV/Hepatitis C). Service barriers throughout rural communities have prompted a need to examine the effectiveness of novel intervention delivery methods (e.g., social media).
This study aims to determine if enhancing an existing HIV prevention intervention with additional modules delivered via Facebook improves service access by examining short-term outcomes among Appalachian women returning to the community following jail release.
Between 2019 and 2022, consenting women from two rural Appalachian jails were randomly selected, screened, interviewed, and randomized to either the National Institute on Drug Abuse (NIDA) Standard alone (n=30) or the NIDA Standard delivered via Facebook post-incarceration (n=30). Women were included in the final sample after completing both baseline and three-month follow-up interviews (N=50). In 2022, bivariate analyses were used to identify differences in drug use, injection drug use, and drug use before sex across intervention groups, and McNemar's test was used to measure changes in these risk behaviors within groups over time.
The percent of individuals reporting past three-month HIV-risk behaviors significantly decreased between baseline and follow-up for both groups. There were no between-group differences in risk behaviors.
Results suggest that high-risk, rural Appalachian women may benefit from HIV prevention interventions delivered via Facebook, particularly during community re-entry following jail release. Facebook intervention delivery is an efficient way to expand the reach of HIV prevention services in a region with known barriers to traditional modes of intervention delivery.
使用毒品且涉及刑事司法系统的阿巴拉契亚农村女性面临更高的健康后果风险（如感染艾滋病毒/丙型肝炎）。农村社区普遍存在的服务障碍促使人们有必要研究新型干预交付方式（如社交媒体）的有效性。
本研究旨在通过考察阿巴拉契亚女性出狱后重返社区的短期结果，确定通过脸书提供额外模块来强化现有的艾滋病毒预防干预措施是否能改善服务获取情况。
在2019年至2022年期间，从阿巴拉契亚农村地区的两所监狱中随机挑选同意参与的女性，进行筛选、访谈，并随机分为仅接受美国国立药物滥用研究所（NIDA）标准干预组（n = 30）或在出狱后通过脸书接受NIDA标准干预组（n = 30）。在完成基线访谈和三个月随访访谈后，女性被纳入最终样本（N = 50）。2022年，采用双变量分析来确定干预组之间在吸毒、注射吸毒和性行为前吸毒方面的差异，并用麦克尼马尔检验来衡量这些风险行为在组内随时间的变化。
两组在基线和随访期间报告过去三个月艾滋病毒风险行为的个体百分比均显著下降。风险行为在组间没有差异。
结果表明，高危的阿巴拉契亚农村女性可能会从通过脸书提供的艾滋病毒预防干预措施中受益，尤其是在出狱后重返社区期间。在一个已知传统干预交付方式存在障碍的地区，通过脸书进行干预交付是扩大艾滋病毒预防服务覆盖范围的有效途径。
