1. Substance Abuse/HIV/Hepatitis Prevention for Adults Reentering the Community (Project SPARC)
Background: San Antonio has an AIDS rate of more than 20 per 100,000 people and a hepatitis C rate (3.0)
more than double that of the state (1.3), making it an area of great need for HIV and hepatitis prevention
services1. Within San Antonio, HIV/AIDS and hepatitis disproportionately affect those involved in the
correctional system. Of incarcerated adults in Texas, 2% are HIV-positive compared to 0.1% of Texas’ general
population2. Likewise, incarcerated populations typically have hepatitis C rates 3-5 times that of the general
population3. A contributing component to this disparity is lack of knowledge regarding the prevention,
transmission, and treatment of HIV/AIDS and hepatitis4.
Objectives: Project SPARC designed and implemented an evidence-based integrated substance abuse,
HIV/AIDS, and hepatitis prevention curriculum to people involved in the criminal justice system for drug-
related crimes to increase HIV/AIDS and hepatitis knowledge among high-risk individuals.
Methods: Project SPARC presented five two-hour classes on substance abuse, HIV, and hepatitis to people
involved in drug court and their sexual partners (N=165) (drug court participants) and a single two-hour brief
version to people in inpatient drug treatment centers (N=118) (treatment participants). All participants
completed a 10-item knowledge test (5 HIV/AIDS questions and 5 hepatitis questions) at enrollment and exit.
Each correct answer was given the score of 10; scores were summed to achieve a total score of 0 to 100. T-test
analyses were performed to assess change in HIV and hepatitis knowledge pre- and post-intervention.
Results: A Paired Sample T-test on all 283 participants showed a mean score of 72.17 at enrollment compared
to 82.77 at exit (t[284]=8.87,p<.001). Drug court participants showed a mean score of 74.39 at enrollment and
86.32 at exit (t[165]=8.72, p<.001), while treatment participants showed a mean score of 69.07 at enrollment
and 77.81 at exit (t[118]=4.11, p<.001).
Conclusions: There was a statistically significant increase of knowledge on HIV/AIDS and hepatitis among
SPARC participants after intervention. Also, a breakdown of our intervention participants showed a significant
increase of knowledge in both drug court and treatment participants, suggesting both the ten-hour and the two-
hour brief curricula were effective in increasing participant knowledge.
Implications: Since increased knowledge is a component of the reduction and prevention of HIV and hepatitis5,
delivery of SPARC curriculum may potentially improve prevention outcomes and contribute to our knowledge
base at the national level concerning effective evidence-based programs for adults in the criminal justice
system.
1
San Antonio Area HIV Health Services Planning Council, 2004
2
Texas Department of Criminal Justice, 2004
3
Kilaen, 2003
4
Kirby, 2005
5
Kirby, 2005
Division of Community Pediatrics