HIV Clinical Trial
Official title:
Prevention of HIV and STDs in Drug Using Women
Women Teaching Women (WTW) is proposed by a team of Washington University investigators who
have focused on HIV prevention efforts among out-of-treatment injecting drug users (IDUs)
and crack cocaine users, since 1988. Our peer-delivered prevention model was successful in
reducing cocaine use among men. The investigators believe no differences were found in drug
and sexual risk behaviors for women because the intervention lacked gender-specificity.
Thus, the investigators propose to tailor our previous intervention to women's needs to
determine the shorter and intermediate term effectiveness of a gender-specific model on
reducing drug use and sexual risks. The urgency for women-focused interventions is
highlighted by increasing HIV/STD rates among women nationwide. The intervention is designed
to bring the HIV prevention message to women in a public health environment. The three-arm
intervention, which targets out-of-treatment drug-using women, will assess the differential
impact of a woman-centered standard intervention alone, the same standard intervention plus
a well-woman exam, and those plus the addition of 4 educational sessions. This proposal
responds to two NIDA PAs: 95-083 (Women's HIV Risk and Protective Behaviors) and 96-018
(Drug Abuse Prevention Intervention for Women and Minorities). Our risk reduction,
epidemiological and technology transfer aims include:
Risk Reduction Aims:
1. Recruit out-of-treatment female drug injectors, heroin, crack/cocaine and
methamphetamine users to into an intervention aimed at reducing high risk sexual and
drug use behaviors. Street outreach, bars and clubs, shelters, health fairs and daycare
facilities will be used to reach these vulnerable women at risk.
2. Administer a modified theory-based, peer-delivered, gender and culture-specific
intervention that encourages women to reduce their high risk drug and sexual behaviors.
Women will be randomly assigned to one of three peer-delivered interventions: a
modified NIDA Cooperative Agreement Standard Intervention (SI), the SI + Well-Woman
Exam (SI+WWE), or the SI+Well-Woman Exam + 4 Educational Sessions (SI+WWE+4ES). The
Standard Intervention will be delivered by peers; the Well-Woman Examination will be
conducted by a nurse practitioner; the four 2 hour educational sessions will be
conducted by peer facilitators from area drug treatment programs paired with a
community mental health or health professional.
3. Assess the effectiveness of the interventions in reducing drug and sexual risk at 4 and
12 months post-intervention, controlling for baseline characteristics.
4. Evaluate the relative cost-effectiveness of each intervention.
Epidemiologic Aim:
5. Assess: a) incidence of HIV, Hepatitis B and C, syphilis, chlamydia and gonorrhea 12
months post-intervention; b) change in HIV risk and drug and alcohol use at 4 and 12
months post-intervention; c) the effect of psychopathology on behavior change at 12
months post-intervention; d) lifetime history of substance abuse and service
utilization for mental and physical problems at baseline.
Technology Transfer Aim:
6. Disseminate findings to the scientific community, practitioners and community members
in formats that are appropriate, understandable, and usable in order that the best
possible women-centered intervention can be developed for reducing HIV risk behaviors.
The investigators propose to create a WebSite and present findings at local, national
and international symposia. Manuals describing the interventions will be developed and
made available to the field.
n/a
Allocation: Randomized, Intervention Model: Parallel Assignment, Primary Purpose: Prevention
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