brief intervention for rural women at high risk for hiv/hcv

Conditions: Acquired Immune Deficiency Syndrome Virus; Hepatitis C; Drug Abuse

Summary: the overall aim of this study is to reduce risk behaviors and increase health and behavioral health service utilization among disadvantaged, drug-using rural women at high risk for hiv and hcv. this project has potential to make a significant contribution to science by providing knowledge about the health, risk behaviors, and service utilization of a vulnerable and understudied group of women during a time of emerging and significant public health risk in a rural appalachian setting. successful completion of the aims of this project will advance the delivery of a low-cost, potentially high impact intervention with implications for a number of other real world settings (such as criminal justice venues) where other disadvantaged high-risk drug users can be identified and targeted for intervention.

specific aim 1: compare the effectiveness of an evidence-based hiv risk reduction intervention (mi-hiv) to hiv education (nida standard) in reducing sex risk behaviors, injection practices, and drug use among a culturally unique sample of disadvantaged, drug-using rural women at high-risk for hiv and hcv. this aim will be accomplished through the random selection of high-risk rural women drug users from rural jails, screening and assessment for high-risk behavior, and random assignment to the hiv-ed or mi-hiv intervention conditions. follow-up interviews at 3, 6, and 12 months in the community post-release will examine changes in high-risk behavior. it is expected that mi-hiv participants will report significantly greater reductions in risky injection drug use practices, other drug use, and sex risk behaviors than women who participate in the hiv-ed condition. specific aim 2: examine mi-hiv intervention engagement as a predictor of community health and behavioral health service utilization (including drug treatment and mental health) at follow-up among disadvantaged, drug-using rural women at high risk for hiv and hcv. this aim will focus on community service utilization during the follow-up period by the intervention and education comparison group, and how health and behavioral health service utilization relates to patterns of hiv/hcv risk behavior. it is expected that mi-hiv participants will utilize more services due to increased motivation for treatment and treatment planning following the brief intervention.

Eligibility criteria:
inclusion criteria: * assist score of 4+ * engagement in at least one sex risk behavior in the past 3 months * willingness to participate in brief intervention sessions * no evidence of cognitive impairment * no evidence of active psychosis (currently experiencing hallucinations) * no self-reported current symptoms of physical withdrawal from a recent episode of drug use * incarceration period of 1 week - 3 months in order to complete intervention sessions exclusion criteria: * assist score of \<4 * no engagement in at least one sex risk behavior in the past 3 months * not willing to participate in brief intervention sessions * evidence of cognitive impairment * evidence of active psychosis (currently experiencing hallucinations) * self-reported current symptoms of physical withdrawal from a recent episode of drug use * incarceration period of less than 1 week or greater than 3 months in order to complete intervention sessions

Keywords: hiv hcv substance abuse women