HIV This Week

Tross S, Campbell AN, Cohen LR, Calsyn D, Pavlicova M, Miele GM, Hu MC, Haynes L, Nugent N, Gan W, Hatch-Maillette M, Mandler R, McLaughlin P, El-Bassel N, Crits-Christoph P, Nunes EV. Effectiveness of HIV/STD sexual risk reduction groups for women in substance abuse treatment programs: results of NIDA Clinical Trials Network Trial. J Acquir Immune Defic Syndr. 2008 Aug 15;48(5):581-9.

Because drug-involved women are among the fastest growing groups with AIDS, sexual risk reduction intervention for them is a public health imperative. The objective was to test effectiveness of HIV/STD safer sex skills building (SSB) groups for women in community drug treatment. This was a randomized trial of SSB versus standard HIV/STD Education (HE); assessments at baseline, 3 and 6 months. The participants were women recruited from 12 methadone or psychosocial treatment programs in Clinical Trials Network of National Institute on Drug Abuse. Five hundred fifteen women with >or=1 unprotected vaginal or anal sex occasion (USO) with a male partner in the past 6 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. There were a 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. The authors concluded that skills building interventions can produce ongoing sexual risk reduction in women in community drug treatment.

Editors’ note: Introducing a new acronym – USO or unprotected sex occasion – this randomised controlled trial found sustained sexual risk reduction 6 months later in women on drug treatment who received a brief, gender-specific, skills-oriented risk reduction intervention delivered by drug treatment staff at community-based clinics. The control group received one health education session compared to the five skills building sessions received by the experimental group, a design that does not permit definitive attribution because of difference in does. Nonetheless, these are impressive results for women who are at high risk for heterosexual acquisition of HIV during drug treatment, as they are often in primary sexual relationships with male drug users and their own substance use may continue, influencing sexual risk.