Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #118082

Traci C. Green, MSc¹, Enrique R. Pouget¹, and Jeannette R. Ickovics, PhD². (1) Chronic Disease Epidemiology, Yale University School of Public Health, 23 Ellsworth Ave., #2, Cambridge, MA 02139, 617 2344427, traci.c.green@yale.edu, (2) Department of Epidemiology and Public Health, Yale University, 135 College Street, Suite 323, New Haven, CT 06510

Increasing evidence suggests that high-risk sexual activity plays a more prominent role than drug-related risks in HIV seroconversion among women drug injectors. Few interventions directly target sex-related HIV risk among women drug injectors and even fewer have been evaluated for efficacy. Clarity on characteristics of previous successful interventions and their evaluation methods is essential to future prevention efforts. A systematic review of peer-reviewed intervention studies was conducted using the following inclusion criteria: an intervention study conducted in the United States; at least 50% of study sample were women who inject drugs, or the intervention or analysis incorporated gender and female injectors made up a significant proportion of the sample; the study aims included reduction of sexual transmission of HIV; and sex-risk reduction outcomes (e.g., condom use) were reported. Data from eligible studies were double extracted. Eleven studies met inclusion criteria for review. Six (55%) reported statistically significant reductions in sexual risk outcomes. These studies involved fewer intervention sessions (3.4 vs. 4.6), elicited higher attendance, and delivered interventions at the individual or community level. Content was more likely to be “women-focused,” included practiced skills-building and aimed to modify peer-influence and community norms. Successful studies employed randomized controlled designs, process evaluations, and sexual behavior composite score outcomes whereas unsuccessful studies suffered from avoidable methodological limitations. This review indicates that women injectors can reduce their sex-related HIV risks. Existing efforts to prevent HIV transmission among women injectors should incorporate gender- and social context-specific sexual risk reduction content and enhance protective behavioral skills.

Learning Objectives:

• Recognize why a gender-specific approach to sex-related HIV risk reduction interventions is necessary, especially among injecting drug users.
• Discuss limitations of the research methods and intervention content in preventive intervention research studies conducted to date.
• Identify characteristics of preventive interventions that successfully reduced sexual risk of HIV in women who inject drugs.

Keywords: Women and HIV/AIDS, Injection Drug Users

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.