EVALUATION OF AN INNOVATIVE PROGRAM TO ADDRESS THE HEALTH AND SOCIAL-SERVICE NEEDS OF DRUG-USING WOMEN WITH OR AT RISE FOR HIV-INFECTION

Drug-using women with or at risk for HIV infection have many competing unmet needs, especially for social services, drug treatment, and medi cal care. High-risk drug-using women were recruited through street out reach, at needle exchange sites, a prison, and local community based o rganizations in New Haven, Connecticut for a study of the service need s of out-of-treatment drug users and the ability of an interactive cas e management intervention (ICM) to address those needs. These women we re administered baseline and follow-up interviews to identify their he alth and social service needs and the degree to which these needs were resolved. The women who chose to enroll in the interactive case manag ement intervention (n = 38) did not differ demographically nor in thei r HIV risk behaviors from those not receiving case management (n = 73) . Provision of ICM was most successful in meeting needs for supportive mental health counseling, basic services, and long term housing. The impact of interactive case management was less evident for the acquisi tion of medical and dental services, which were accessed comparably by women not receiving the intervention. Overall, the women who enrolled in the ICM intervention showed a significant decrease in the number o f unmet service needs as compared to those who did not enroll. Multipl e contacts were required by the case manager to establish trust and to resolve the unmet service needs of these high-risk women. Women with or at risk for HIV infection can be effectively engaged in an ICM inte rvention in order to meet their multiple unmet service needs, although such interventions are time-and-labor intensive.