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 advancing knowledge about the health disparities, high-risk behaviors (injection drug use, sex risk), and service utilization of this high-risk, vulnerable, an understudied group of women during a time of emerging and significant public health risk in an Appalachian rural setting. This project will incorporate standardized screening (NIDA-modified ASSIST) to identify high-risk rural women drug users from jails, including injectors. Consenting women (N=350) will be asked to participate in a baseline interview, and will then be randomly assigned to one of two study groups: (1) HIV Education (HIV- Ed n=175) which includes the NIDA standard pre and post-test counseling, HIV and HCV rapid testing, and an information packet on existing community drug abuse and HIV/HCV resources;or (2) Motivational Interviewing- based HIV Risk Reduction (MI-HIV n=175) which, in addition to what is received in the HIV-Ed group, also includes an evidence-based brief intervention for high-risk women focused on an individualized plan for enhancing motivation to reduce risk behaviors and to use health and behavioral health services in the community.
Specific aims i nclude: (1) to 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;and (2) to 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 project is innovative because it 1) targets a high-risk and understudied group of women, 2) uses brief intervention to not only reduce risk behavior but also to enhance motivation for using community health and behavioral health resources, and 3) utilizes a real-world setting to identify high-risk women drug users. The long-term goal of this study is to increase access to health and behavioral health services in order to improve the quality of health of high-risk rural women.
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.
|Staton, Michele; Ciciurkaite, Gabriele; Oser, Carrie et al. (2018) Drug Use and Incarceration among Rural Appalachian Women: Findings From a Jail Sample. Subst Use Misuse 53:931-941|
|Staton, Michele; Ciciurkaite, Gabriele; Havens, Jennifer et al. (2018) Correlates of Injection Drug Use Among Rural Appalachian Women. J Rural Health 34:31-41|
|Strickland, Justin C; Staton, Michele; Leukefeld, Carl G et al. (2018) Hepatitis C antibody reactivity among high-risk rural women: opportunities for services and treatment in the criminal justice system. Int J Prison Health 14:89-100|
|Dickson, Megan F; Staton, Michele; Tillson, Martha et al. (2018) The Affordable Care Act and Changes in Insurance Coverage and Source of Health Care among High-risk Rural, Substance-using, Female Offenders Transitioning to the Community. J Health Care Poor Underserved 29:843-863|
|Staton, Michele; Strickland, Justin C; Webster, J Matthew et al. (2018) HIV Prevention in Rural Appalachian Jails: Implications for Re-entry Risk Reduction Among Women Who Use Drugs. AIDS Behav 22:4009-4018|
|Vickers Smith, Rachel; Boland, Elaine M; Young, April M et al. (2018) A qualitative analysis of gabapentin misuse and diversion among people who use drugs in Appalachian Kentucky. Psychol Addict Behav 32:115-121|
|Tillson, Martha; Strickland, Justin C; Staton, Michele (2017) Age of First Arrest, Sex, and Drug Use as Correlates of Adult Risk Behaviors Among Rural Women in Jails. Women Crim Justice 27:287-301|
|Staton, Michele; Strickland, Justin C; Tillson, Martha et al. (2017) Partner Relationships and Injection Sharing Practices among Rural Appalachian Women. Womens Health Issues 27:652-659|
|Dickson, Megan F; Staton-Tindall, Michele; Smith, Kirsten E et al. (2017) A Facebook Follow-Up Strategy for Rural Drug-Using Women. J Rural Health 33:250-256|
|Otis, Melanie D; Oser, Carrie B; Staton-Tindall, Michele (2016) Violent Victimization and Substance Dependency: Comparing Rural Incarcerated Heterosexual and Sexual Minority Women. J Soc Work Pract Addict 16:176-201|
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