This pilot study is intended to reduce the risk of HIV transmission in women being treated for substance abuse by decreasing their likelihood of engaging in unsafe sexual behaviors. Although both parenteral and nonparenteral drug use has been associated with increased HIV risk behavior in general, few randomized controlled studies have been published which impact the sexual risk behaviors of substance abusing women. Since women continue to evidence disproportionate increases in HIV incidence, the development of interventions designed to impact sexual risk in these high risk women is imperative. The study will be a randomized controlled trial comparing two conditions across repeated measures: an HIV skills-based prevention intervention condition and a health education attention control condition. Following screening, enrollment, and baseline assessment, intervention participants will be exposed to 7 program sessions: (1) a motivational interview (MI) focusing on individual sexual risk behaviors, (2) HIV education, (3) latex barrier use skills (e.g., condoms), (4) assertiveness and unsafe sex refusal skills, (5) safer sex negotiation skills, (6) self-management skills, and (7) a risk reduction feedback and planning (RRFP) session, occurring one month following the self- management skills session. The MI and RRFP sessions will be conducted individually. All other sessions will be implemented in a group format. All participants, including the attention control group participants, will undergo HIV risk screening and referral to community resources as part of their standard substance abuse treatment program. Approximately 74 women are expected to complete the study. They will be recruited from a local drug/alcohol treatment program. The intervention will be initiated while women are still enrolled in substance abuse treatment. Dependent measures will include measures of sexual risk behaviors and drug/alcohol use during the 6 months following discharge. Analyses will test the intervention's effect on frequency of barrier-protected sexual behavior, self-reported number of sexual partners, and frequency of sexual events occurring while under the influence of alcohol or other drugs. HIV incidence among women continues to rise disproportionately. An intervention which effectively reduces sexual risk among high risk women could have a substantial impact on HIV transmission. This pilot study will examine the impact of recently recommended intervention strategies, informing the development and modification of future HIV risk reduction interventions for substance-abusing women at risk.
