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HIV/STD Risk Reduction Skills-Building Intervention for Women

Presented at the 2010 SCAADAC Conference, Charleston, SC Beverly W. Holmes, MSW Beatrice Koon, MSW Candidate (Winthrop University). HIV/STD Risk Reduction Skills-Building Intervention for Women. Outline. Introductions Background Activity: Let’s Talk About Sex! Overview of Intervention

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HIV/STD Risk Reduction Skills-Building Intervention for Women

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  1. Presented at the 2010 SCAADAC Conference, Charleston, SC Beverly W. Holmes, MSW Beatrice Koon, MSW Candidate (Winthrop University) HIV/STD Risk Reduction Skills-Building Intervention for Women

  2. Outline • Introductions • Background • Activity: Let’s Talk About Sex! • Overview of Intervention • Activity: Challenging Rationalizations • Demonstrations: Wrap it Up! • Activity: Safer Sex Negotiations • Wrap-up • Questions

  3. HIV/STD Safer Sex Skills Groups For Women In Methadone Maintenance or Drug-Free Outpatient Treatment Principal Investigator Susan Tross, Ph.D. Columbia University, New York, NY

  4. Community Treatment Programs • 12 sites • Methadone programs, psychosocial rehab • Geographical diversity • LRADAC

  5. Community Treatment Programs Locations . Seattle Norwalk Hartford . Staten Is. Philadelphia Toledo . Huntington . SanFrancisco HighPoint Raleigh . . Santa Fe Columbia Rancho Cucamonga

  6. HIV Risk Behavior • Engagement in substance abuse treatment is associated with reduction in HIV risk behaviors. • However, many women and men continue to engage in high risk sexual behavior while in treatment. • Most treatment programs provide a one hour HIV prevention information session which is know as treatment as usual. • Drug abusing women are among the fastest growing groups with AIDS. • There fore, sexual risk reduction intervention for these women is a public health necessity

  7. Meta analyses indicate the more efficacious HIV prevention interventions utilize: • Separate sessions for ♂/♀, • A variety of techniques • Condom demonstrations, • Skills training exercises, • Peer group discussions,

  8. Study Purpose To compare a one session HIV health education session (HE) to a five session (SSB), gender specific HIV risk reduction intervention for women in community treatment programs

  9. Participants 515 women with > one unprotected (vaginal or anal) sex occasion (in past 6 months) with a male partner, of 824 screened, were randomized.

  10. Interventions • In SSB (WORTH), five 90-minute groups used problem-solving and skills rehearsal to increase HIV/STD risk awareness and condom use and partner negotiation skills. • In HE, one 60-minute group covered HIV/STD disease, testing, treatment, and prevention information.

  11. Results • A significant difference in mean USOs was obtained between SSB and HE over time . • At 3 months, significant decrements were observed in both conditions. • At 6 months, while SSB maintained this decrement, HE returned to baseline. Women in SSB had 29% fewer USOs than those in HE.

  12. Unprotected Sexual Occasions at Baseline, 3 and 6 month

  13. Unprotected Sexual Occasions Among Completers at Baseline, 3 and 6 month

  14. Unprotected Sexual Occasions Among Non-Completers at Baseline, 3 and 6 month

  15. Conclusions • An intensive gender specific HIV prevention intervention was associated with greater sexual risk reduction among women in substance abuse treatment compared to a standard HIV education intervention. • Among those patients who attended study intervention sessions, an even larger effect was observed. • The effect remained strong at the six month follow up.

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