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Article << Previous     |     Next >>   Contents Vol 9(5)

Court-based participatory research: collaborating with the justice system to enhance sexual health services for vulnerable women in the United States

Alexis Roth A B F , J. Dennis Fortenberry A B , Barbara Van Der Pol A B , Joshua Rosenberger C , Brian Dodge B , Janet Arno A D , Janine Waters D , David Certo E and Michael Reece B

A Indiana University School of Medicine, Indianapolis, IN 46202, USA.
B Center for Sexual Health Promotion, Indiana University School of Health, Physical Education and Recreation, Bloomington, IN 47405, USA.
C Department of Global and Community Health, George Mason University, Fairfax, VA 22030, USA.
D Bell Flower STD Control Program, Marion County Public Health Department, Indianapolis, IN 46202, USA.
E Indianapolis Community Court, Indianapolis, IN 46203, USA.
F Corresponding author. Email: almroth@iupui.edu

Sexual Health 9(5) 445-452 http://dx.doi.org/10.1071/SH11170
Submitted: 1 December 2011  Accepted: 22 May 2012   Published: 5 October 2012


 
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Abstract

Background: Although jail screening programs have an important role in the diagnosis and treatment of sexually transmissible infections (STI) and HIV among incarcerated individuals, many arrestees are not screened before release. Justice-involved women are at particularly high risk for these conditions because of individual risk behaviour as well as other network-level risk factors. Court-based programs could provide a critical bridge between these women, STI risk counselling and health services. This formative study explored the features of a program that would encourage STI testing among court-involved women. Further, we describe how community-based participatory research principles were adapted for use in a court setting and the resulting justice–public health partnership. Methods: Using semistructured interviews and focus group discussions, we explored issues related to health-seeking behaviours, perceived gaps in services for high-risk women and the components of a court-based screening program. Results: Six focus groups were conducted with women with a history of commercial sex work and staff from the court, as well as local organisations providing HIV and social support services for high-risk women. Community-based participatory research (CBPR) principles facilitated development of relevant research questions and equitable processes, and assisted partners to consider individual and sociostructural sources of health disparities. Discussion: Although not every principle was applicable in a court setting, the CBPR framework was helpful for building cohesion and support for the project. We provide a description of how CBPR principles were operationalised, describe the key lessons learned and discuss the implications for CBPR projects in a community court.

Additional keywords: community-based participatory research, community court, sex workers, sexually transmitted infections, testing.


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