Despite more than 15 years of behavioral intervention research seeking to reduce HIV risk behaviors among drug-using persons, drug-using women, across drug categories, remain at very high risk of HIV infection through unsafe sex. Available epidemiological data suggest that women drug users are at the highest risk of HIV infection relative to other risk groups in the US. State-of-the-art HIV counseling and testing (CT) prevention approaches are insufficient to address women's risk. The proposed project uses a woman-specific prevention approach, already tested for feasibility and short-term behavior change on diverse cultural groups. The intervention (BESTBET) seeks to respond to the public health emergency among drug-using women by addressing the concrete realities of economic and emotional dependence on an often-risky sex partner, which provide the foundation of women's HIV risk. Based on Body Empowerment Theory, the proposed intervention provides interactive, skills-based learning, and offers a range of new protection technologies to women, including the female condom. Guided by an Advisory Board of national experts on drug-using women, and sexual behavior, the study seeks to empower women by creating a sense of control over one's body and health, increased community and peer support for new norms, and greater usage of healthful community resources (drug -- related, medical, social). Group intervention sessions lead by trained """"""""near-peer"""""""" counselors will focus on risk-reduction for sexual and drug-related HIV risk, and on combined drug-sex risk behavior. This 3-year, randomized controlled trial will recruit 240 out-of-treatment drug-using women in West Philadelphia. Both arms will first receive an enhanced HIV CT module composed of 2 short individualized counseling sessions. The study will test the effects of adding a multiple-group session model administered over 5 weeks, with 2 boosters, in the form of 'reunion sessions,"""""""" against a control condition receiving only the CT module. Follow-up assessments for behavioral outcomes (via audio-assisted computer interview) and biological/serological outcomes (incidence of gonorrhea, Chlamydia and Trichomonas, HIV and syphilis) will occur at 6-month intervals over 12 months. Treatment of incident infections will provide for valid measures of STD incidence. A strong relationship with community organizations will be sought, including: community input into the study throughout, training of community group leaders in study techniques and technologies, the distribution of women's """"""""sexual risk reduction kits,"""""""" and adoption of study activities by community groups by the time of study.
| Gollub, Erica L; Cyrus-Cameron, Elena; Armstrong, Kay et al. (2013) Basic body knowledge in street-recruited, active drug-using women enrolled in a ""body empowerment"" intervention trial. AIDS Care 25:732-7 |
| Gollub, Erica; Cyrus-Cameron, Elena; Armstrong, Kay et al. (2013) Active Drug-Using Women Use Female-Initiated Barrier Methods to Reduce HIV/STI Risk: Results from a Randomized Trial. ISRN Addict 2013:768258 |
| Gollub, Erica L; Armstrong, Kay; Boney, Tamara et al. (2010) Correlates of trichomonas prevalence among street-recruited, drug-using women enrolled in a randomized trial. Subst Use Misuse 45:2203-20 |
