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Incarcerated women are a critical population for targeted HIV/STI prevention programming; however, there is a dearth of evidence-based, gender-specific behavioral interventions for this population. Systematically adapting existing evidence-based interventions (EBIs) can help fill this gap. We illustrate the adaptation of the HIV/STI prevention EBI, Project Safe, for use among incarcerated women and delivery in prisons. Project POWER, the final adapted intervention, was developed using formative research with prison staff and administration, incarcerated and previously incarcerated women, and input of community advisory boards. Intervention delivery adaptations included: shorter, more frequent intervention sessions; booster sessions prior to and just after release; facilitator experience in prisons and counseling; and new videos. Intervention content adaptations addressed issues of empowerment, substance use, gender and power inequity in relationships, interpersonal violence, mental health, reentry, and social support. This illustration of the adaption process provides information to inform additional efforts to adapt EBIs for this underserved population.

African Americans experience HIV and AIDS at a rate 10 times greater than the U.S. White population. Although there have been advances in HIV risk-reduction strategies, these efforts have not been as successful in decreasing HIV infection in the African American population. This article reviews the research base of HIV prevention interventions to identify research that will lead to the development of more effective prevention strategies for African Americans. Major limitations found in the research include the exclusion of African Americans in studies, particularly those at higher risk, and the lack of using culturally based theory to guide research. Recommendations for improving research are offered. They include conducting research that focuses on structural interventions rather than individuals, controlling for diversity within the African American population, defining culture when using it in research, and developing a cadre of African American researchers involved in prevention intervention studies.

African American women account for 66% of new HIV infections among U.S. women, and many are not aware of their status. The authors compared three strategies (targeted outreach, alternate venues, and social networks) to recruit African American women for HIV testing in Houston, New York City, Baltimore, and Dayton. A quasi-experimental design (N = 4,942) was used to compare HIV-positivity rates and to identify risk factors for previously undiagnosed infection. A total of 2.1% of the women were newly diagnosed with HIV. The proportion newly identified as HIV-positive did not differ significantly among the three strategies (2.4% for social networks, 1.7% for both targeted outreach and alternate venues). However, the social networks strategy recruited women with greater risk behaviors and other characteristics associated with newly identified HIV infection and thus may be effective at reaching some high-risk women before they become infected. A combination of recruitment strategies may be warranted to reach various subgroups of African American women at risk for HIV.

The U.S. inmate population increased by 700% between 1970 and 2005 (Austin, Naro, & Fabelo, 2007), mainly because correctional policies criminalize drug addiction. Almost one half of all prisoners are drug abusers (Karberg & James, 2002) despite evidence from molecular and imaging studies that addiction is a brain disorder with a strong genetic component (Chandler, Fletcher, & Volkow, 2009). The composition of prison admissions has shifted away from perpetrators of violent crimes towards less serious offenses such as parole violations and drug offenses (Clear, 2007). These offenses are largely responsible for the steep increases in the number of people who are incarcerated. Mauer (2006) notes that since there are no direct victims in drug selling and possession police rarely receive reports of these activities. Also, drug law enforcement is far more discretionary than for other offenses. The police decide when and where they will seek out people to arrest and most importantly what priority they will place on enforcing drug laws. Nearly six in ten persons in state prisons for a drug offense have no history of violence or significant selling activity. In 2005 four out of five drug arrests were for possession and only one out of five were for drug sales (Webb, 2007). States that have high numbers of drug arrests usually have higher incarceration rates (Mauer) and counties with burgeoning unemployment, persistent poverty and large percentages of African Americans have the highest incarceration rates for drug offenses (Beatty, Petteruti, & Ziedenberg, 2007).

More than 6 million people are under some form of criminal justice supervision in the United States on any given day. The vast majority are arrested in and return to urban, low-income communities. These are men, women, and adolescents with high rates of infectious diseases such as HIV/AIDS, other sexually transmitted diseases (STDs), and tuberculosis (TB), as well as substance abuse and other health problems. A review of recent literature indicates that an increasing problem for these populations is that they have had little prior access to primary health care or health interventions, and many are returning to their communities without critical preventive health information and skills, appropriate medical services, and other necessary support. Periods of incarceration and other criminal justice supervision offer important opportunities to provide a range of health interventions to this underserved population, and general evaluations show the potential for this strategy. Public health and criminal justice agencies have the expertise and should collaborate to provide interventions needed by incarcerated populations. Moreover, many recently released inmates require primary care for HIV/AIDS, other STDs, and TB. Consequently, timely discharge planning is essential, as are linkages with community-based organizations and agencies that can provide medical care, health education, and necessary supportive services.

The theme of the October 2005 issue of the Journal was the public health consequences of imprisonment. This issue illuminated the wide-ranging health care needs of the more than 2.2 million men—most of whom are African American—who are incarcerated in the United States. Persistent health disparities characterize impoverished communities with large numbers of men who are locked away with limited access to quality health care and treatment,1 and these disparities are fueled by cycles of recidivism. Each year more than a half million offenders move back and forth between their communities and prison.2 The 1990s prison boom was associated with increased wage inequality for young, poorly educated African American men with prison records.3 The high rates of incarceration of young African American men result in racial and ethnic wage disparities (low wages, unemployment, family instability, recidivism, and restrictions on political and social rights)4 that exacerbate their lack of access to health care, treatment, and prevention. These are the people for whom the mission of public health is intended. Jails and prisons are gateways for public health professionals, whose research and practice help ensure conditions in which all people can be healthy.5 Burgeoning HIV infection rates among African American men, many of whom have been incarcerated, make this disease the most potent symbol of health disparity in the United States. Furthermore, disparities in incarceration rates for African American men lower the ratio of men to women in African American communities. This situation promotes partner concurrency, which is a known risk factor for the transmission of HIV and other sexually transmitted diseases.6 Incarcerated populations, therefore, constitute the new public health mission field for evidence-based interventions and comprehensive case management. Fortunately, collaborations between correctional health and community organizations, including faith-based programs, are producing promising prevention and prisoner reentry programs.7(p1682),8 A nationwide conversation must begin to challenge correctional practices and legal policies that exacerbate health disparities. Broad questions must be asked about the relationships between causes of crime, sentencing policies, and health care delivery in correctional settings and about the aggregate influence of these factors on the health of African American communities. Answers to these compelling questions are possible if we make a national commitment to public health and to correctional policies that protect the most vulnerable people among us.

This study investigated relationships between the variety of infants' social experience and their cognitive competence and motivation to master the environment. A measure of the variety of cognitively-oriented social activities with regular caregivers was significantly related to the Bayley Mental Development Index at 13 months and to three of the four McCarthy Scales of Children's Abilities at 31/2 years. The relationships were especially strong with language development at both 1 and 31/2 years. Some relationships between the variety of cognitively-oriented caregiver activities and mastery motivation were found at 1, but not at 31/2 years of age. Infant experience was not related to 13-month motor development.

A technique for measuring one aspect of infants' motivation to master the environment—persistence at tasks—is described. Forty-four 13-month-old infants engaged in persistent, task-directed behaviors about 60% of the time during 11 mastery tasks. As a measure of concurrent validity, persistence during a Bayley examination was rated by another examiner; a moderately high correlation ( r = .48) was found. Significant relationships were also found between persistence at the mastery tasks and Bayley MDI, suggesting considerable intertwining of cognition and motivation in infancy. In a subsample of 25 infants tested at 6 months, significant relationships were found between goal-directedness, an index of directed persistent behavior, and both cognitive functioning and infant competence on the mastery tasks at 13 months. Several aspects of the 6-month environments of these 25 infants, especially maternal kinesthetic and auditory stimulation, maternal responsiveness, and responsiveness of toys were related to persistence and competence at 13 months.

Intraventricular hemorrhage (IVH) is the most common brain lesion documented at autopsy in 40% to 50% of preterm infants with birth weights less than 1,500 g (Papile, Burstein, Burstein, & Kofler, 1978). The incidence of IVH remains high in the very low birth weight preterm population because of improved survival rates of infants with increasingly shorter gestations in whom IVH insult can be expected (Shinnar, Molteni, Gammon, D’Souva, Altman, & Freeman, 1982). Ultrasonographic studies conducted within 2 to 10 days of preterm birth can detect IVH in approximately one-third of infants of very low birth weight (less than 1,500 g) (Ahmann, Lazzara, Dykes, Brann, & Schwartz, 1978; Papile et al., 1978).