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