1. HIV/STD Risk Reduction Skills- Building Intervention for Women Presented at the 2010 SCAADAC Conference, Charleston, SC Beverly W. Holmes, MSW Beatrice Koon, MSW Candidate (Winthrop University)

2. Outline Introductions Background Activity: Let’s Talk About Sex! Overview of Intervention Activity: Challenging Rationalizations Demonstrations: Wrap it Up! Activity: Safer Sex Negotiations Wrap-up Questions

3. HIV/STD Safer Sex Skills Groups For Women In Methadone Maintenance or Drug-Free Outpatient Treatment Principal Investigator Susan Tross, Ph.D. Columbia University, New York, NY

4. Community Treatment Programs 12 sites Methadone programs, psychosocial rehab Geographical diversity LRADAC

5. Community Treatment Programs Locations Seattle San Francisco Hartford Philadelphia Staten Is. High Point Norwalk Rancho Cucamonga Santa FeColumbia Toledo Huntington Raleigh......

6. HIV Risk Behavior  Engagement in substance abuse treatment is associated with reduction in HIV risk behaviors.  However, many women and men continue to engage in high risk sexual behavior while in treatment.  Most treatment programs provide a one hour HIV prevention information session which is know as treatment as usual.  Drug abusing women are among the fastest growing groups with AIDS.  There fore, sexual risk reduction intervention for these women is a public health necessity

7. Meta analyses indicate the more efficacious HIV prevention interventions utilize: Separate sessions for ♂ / ♀, A variety of techniques Condom demonstrations, Skills training exercises, Peer group discussions,

8. Study Purpose To compare a one session HIV health education session (HE) to a five session (SSB), gender specific HIV risk reduction intervention for women in community treatment programs

9. Participants 515 women with > one unprotected (vaginal or anal) sex occasion (in past 6 months) with a male partner, of 824 screened, were randomized.

10. Interventions In SSB (WORTH), five 90-minute groups used problem-solving and skills rehearsal to increase HIV/STD risk awareness and condom use and partner negotiation skills. In HE, one 60-minute group covered HIV/STD disease, testing, treatment, and prevention information.

11. Results A significant difference in mean USOs was obtained between SSB and HE over time. At 3 months, significant decrements were observed in both conditions. At 6 months, while SSB maintained this decrement, HE returned to baseline. Women in SSB had 29% fewer USOs than those in HE.

12. Unprotected Sexual Occasions at Baseline, 3 and 6 month

13. Unprotected Sexual Occasions Among Completers at Baseline, 3 and 6 month

14. Unprotected Sexual Occasions Among Non-Completers at Baseline, 3 and 6 month

15. Conclusions An intensive gender specific HIV prevention intervention was associated with greater sexual risk reduction among women in substance abuse treatment compared to a standard HIV education intervention. Among those patients who attended study intervention sessions, an even larger effect was observed. The effect remained strong at the six month follow up.