Readiness to change HIV/HCV risk behavior among young African American IDUs

Objective: To examine the differential effects of self-efficacy and self-esteem on stimulating readiness to change HIV/HCV sexual and drug use risk behaviors in a cohort of young African American IDUs participating in a longitudinal study comparing the relative efficacy of 3 HIV/HCV risk reduction interventions. Methods: As part of a NIDA-funded risk reduction intervention study 211 incarcerated young African American IDUs were randomized to one of three intervention arms (counseling and testing (CT), pharmacy syringe purchase (PSP), and a client centered behavioral intervention (CCBI)). HIV, HCV, and Chlamydia laboratory data as well as baseline interview data measuring readiness to change, self-esteem, self-efficacy, and sexual and drug use risk behaviors were compared to parallel data gathered 6 months post incarceration. Results: At 6 month follow-up, syringe sharing was significantly reduced across all interventions by at least 25%. Increased self-efficacy and self-esteem resulted in increased readiness to change (r=.72; p<.01; r=.68; p<.01 respectively) which was significantly positively associated with HIV/HCV risk reduction (r=.71; p<.01). Conclusions: HIV/HCV risk reduction interventions that include increasing self-efficacy and self-esteem are likely to result in significant HIV/HCV risk behavior change and should be included in intervention and prevention efforts