(Taken from abstract). The Multnomah County Health Department and the Oregon Health Division propose a randomized controlled trial to test two interventions to reduce women offenders' HIV-related risk behavior and exposures to domestic violence. 870 HIV seronegative female offenders at risk of HIV infection (i.e., females who inject drugs, use crack, are sex partners of IDUs, or trade sex for drugs, money, or subsistence) will be recruited through outreach at existing county jail HIV testing sites. Subsequent to their release from jail, participants will be randomly assigned to one of three study conditions: Participants in the control condition will receive the standard of care-referrals for needed services. Women in the HIV prevention condition will receive three-month case management and intensive HIV risk reduction intervention. The risk reducing intervention will consist of multiple sessions of a motivational enhancement procedure designed to assess the participant's HIV risk behaviors, give feedback, assess readiness for behavior change, and develop a tailored, stage-based behavior change intervention. The behavioral plan will be reviewed at the next intervention session. Women in the HIV and domestic violence prevention condition will receive the same intervention as those in the second condition, plus assessment and intervention for the prevention of domestic violence and coerced risk activity. All participants will complete face-to-face assessment interviews measuring their drug-related behaviors, sexual risk behaviors, experiences of domestic violence, psychological well being, behavioral self-efficacy and relationship processes. Assessments will occur at enrollment, at the completion of the intervention (month 4), and follow-ups (months 7 and 10). Testing for HIV antibodies will occur at baseline and at month 10. Latent growth modeling techniques will be used to investigate whether the HIV prevention intervention facilitates reduction in HIV sexual and needle risk behaviors, and to investigate if the addition of a domestic violence prevention component is associated with further reductions in HIV risk behaviors or reductions in domestic violence and coerced risk activity. The effects of these interventions on hypothesized mediators of risk behaviors will also be determined. Regression and profile techniques will be used to identify participant characteristics related to the reduction of risk behaviors.
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