Effectiveness of HIV/STD sexual risk reduction groups for women in substance abuse treatment programs: Results of a NIDA Clinical Trials Network trial.

Since drug-involved women are among the fastest growing groups with AIDS, sexual risk reduction intervention for them is a public health imperative. The objective of this study, part of protocol CTN-0019 (“Reducing HIV/STD Risk Behaviors: A Research Study for Women in Drug Abuse Treatment”), was to test the effectiveness of HIV/STD safer sex skills building (SSB) groups for women in community drug treatment. The study used a randomized trial of SSB versus standard HIV/STD Education (HE), with assessments at baseline, 3, and 6 months. Women were recruited from 12 methadone or psychosocial treatment programs in the National Drug Abuse Treatment Clinical Trials Network. Five hundred and fifteen women who had had at least one unprotected vaginal or anal sex occasion (USO) with a male partner in the past six months were randomized. In SSB, five 90-minute groups used problem solving and skills rehearsal to increase HIV/STD risk awareness, condom use, and partner negotiation skills. In HE, one 60-minute group covered HIV/STD disease, testing, treatment, and prevention information.

The main outcome measured was the number of USOs at follow-up. A significant difference in mean USOs was obtained between SSB and HE over time (F = 67.2, P < 0.0001). At 3 months, significant decrements were observed in both conditions. At 6 months, SSB maintained the decrease and HE returned to baseline (P < 0.0377). Women in SSB had 29% fewer USOs than those in HE. This study demonstrates that skills building interventions can produce ongoing sexual risk reduction in women in community drug treatment.

Related protocols: CTN-0019