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Effectiveness of two HIV/AIDS interventions for drug-involved women sex workers

James A. Inciardi, PhD, Hilary L. Surratt, MPhil, and Steven P. Kurtz, PhD. University of Delaware Research Center, University of Delaware, 2100 Ponce de Leon Blvd., Suite 1180, Coral Gables, FL 33134, 305-529-1911, kurtzmiami@aol.com

Background: Street sex workers are a marginalized group at elevated risk for HIV infection. This study investigates drug and sexual risk behaviors among women sex workers in Miami, and examines the effectiveness of two HIV risk reduction programs. Methods: Women are recruited using targeted sampling techniques. Following informed consent, they are interviewed regarding drug use and sexual behaviors, and randomly assigned to receive the NIDA Standard Intervention or a Sex-Worker Focused Intervention. Both interventions are delivered by peers former drug using sex workers now in recovery. Clients receive voluntary HIV testing, and follow-up interviews occur 3, 6, and 12 months hence. Results: Of 652 women enrolled into the study, the median age was 38 years; the majority were African-American (65.3%), and 42.3% were homeless. The primary drugs used in the past month were alcohol (77.6%), and crack (72.9%). At baseline, 51% reported unprotected vaginal sex during the past month with a mean of 19.7 sexual partners. Overall, 23% tested positive for HIV. Analyses of 3-month follow-up data demonstrated that, regardless of intervention group, the women reduced their HIV risk behaviors. Specifically, women significantly reduced days using alcohol (p=.000) and crack (p=.000), as well as the number of sex partners in the past month (p=.000), and the number of violent encounters with customers (p=.004). Conclusions: These data, combined with indicators from focus groups and in-depth interviews with clients, suggest that both interventions are effective in reducing risk, and that a key component of this process is engaging the clients by using peer interventionists.

Learning Objectives:

Keywords: HIV Interventions, Sex Workers

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Women and HIV/AIDS

The 132nd Annual Meeting (November 6-10, 2004) of APHA