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IUHR - Reducing HIV Risk Behaviors in Women

Reducing HIV Risk Behaviors in Women with Co-existing Substance Abuse and Mental Health Disorders and Trauma Histories: Preliminary Results from the Boston Site of a National Study

Authors:
Hortensia Amaro, Ph.D., Northeastern University
Annie Zhang, New England Research Institutes
Mary Jo Larson, New England Research Institutes
Lisa D. Miller, Ph. D., New England Research Institutes
Beth Mohr, New England Research Institutes
Luz Lopez, MSW, MPH, Boston Public Health Commission
Miriam C. Chernoff, Ph.D., Northeastern University

Funding Resource:

Substance Abuse and Mental Health Services Administration (SAMHSA) of the U.S. Department of Health and Human Services.

Body of Abstract

Purpose:
The Institute on Urban Health Research, the Boston Public Health Commission (BPHC), the Boston Medical Center Department of Psychiatry, and the New England Research Institutes participated in a national study of adult women with coexisting mental health and substance abuse (SA) disorders who were also victims of violence. These women are at high risk for developing HIV/AIDS. We present preliminary study results on whether the integrated service intervention reduces HIV risk behavior (unprotected sex). Participants received either standard or enhanced addictions treatment. Enhanced services included a skills-based 25-session trauma-recovery group with an HIV prevention component and a 15 hour peer-leadership program.

Methods:
The study was a longitudinal, comparative (non-randomized) trial. Women were recruited from 9 SA treatment sites, 5 of which were intervention sites and 4 comparison sites. Data were collected via structured face-to face interviews at study entry and 6, and 12-month follow-ups, and at 3 and 9 months by phone. Multiple logistic regression analyses were used.

Results:
Data were collected from 342 women undergoing Methadone, outpatient, or residential SA treatment. N=181 women received the enhanced services. Two thirds of these women were minority (Latina, Black). Fewer women receiving the intervention reported high risk sex behavior at 6 months, OR=0.29 (N=218, 95% CI=0.12, 0.67). Six-month scores on a relationship power scale were inversely associated with HIV risk behavior at that time. Age (younger) and race/ethnicity (Black) also were correlated with risky sex behavior.

Conclusions:
Integration of trauma treatment into substance abuse treatment can be an effective method for reducing sexual risk behaviors among women with a history of trauma and mental illness.

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