EVALUATION OF AN HIV RISK REDUCTION INTERVENTION FOR WOMEN ENTERING INPATIENT SUBSTANCE-ABUSE TREATMENT

Objectives. Interventions to lower HIV risk behavior among drug users have concentrated on reduction of high risk injection practices. Less attention has been directed to non-injecting drug users and drug-invol ved women. Female non-injecting drug users (e.g., women who abuse alco hol or crack cocaine) are also at substantial risk for sexual transmis sion of HIV due to multiple partners, partners who self-inject and sha re needles, exchange of sex for drugs, coerced sex, high rates of sexu ally transmitted diseases, and low rates of condom use. This study com pared the effectiveness of an educational intervention (EC) against a behavior skills training intervention (BST) in reducing sexual risk be havior among women (N=117) court-ordered into inpatient drug treatment . Methods. Participants were assessed at baseline, post intervention, and 2 months after discharge from the drug treatment facility. Results . Women in both conditions reported high rates of sexual risk behavior prior to the intervention. Women in both conditions had more positive attitudes toward HIV prevention and reported greater partner agreemen t with condom use at the post intervention assessment. However, these changes were not maintained at follow-up for women in the EC condition , whereas women in BST continued to show improvement post discharge. W omen in the BST condition showed marked, while women in EC showed litt le improvement in communication skills and no improvement in condom ap plication skill. At follow-up, women in both conditions had reduced dr ug use and drug-related high risk sex activities. BST women had increa sed their condom use while women in EC evidenced a decrease. Condom us e increased from 35.7% to 49.5% of vaginal intercourse occasions for B ST women and decreased from 28.8% to 15.8% for women in EC. Conclusion s. Results suggest a brief skills training intervention embedded in dr ug treatment programs can reduce sexual risk for HIV-infection after d ischarge.