%0 Journal Article
%T Active Drug-Using Women Use Female-Initiated Barrier Methods to Reduce HIV/STI Risk: Results from a Randomized Trial
%A Erica Gollub
%A Elena Cyrus-Cameron
%A Kay Armstrong
%A Tamara Boney
%A Delinda Mercer
%A Danielle Fiore
%A Sumedha Chhatre
%J ISRN Addiction
%D 2013
%R 10.1155/2013/768258
%X Background. We tested an original, woman-focused intervention, based on body empowerment, and female-initiated barrier methods, including the female condom (FC) and cervical barriers. Methods. Eligible women were >= 18 years of age, HIV seronegative, and active drug users, reporting 30% or greater unprotected sex acts. Both controls (C) and intervention (I) participants received enhanced HIV/STI harm reduction counseling. I participants underwent 5 additional weekly group sessions. We compared change in frequency of unprotected vaginal intercourse across arms at 12 months. Results. Among 198 enrolled women, over 95% completed followup. Two-thirds were African-American; most of them used crack, had a primary partner, and reported sex exchange. In paired t-tests from baseline to followup, the frequency of unprotected vaginal sex dropped significantly for I (primary , nonprimary ) and C (primary , nonprimary ) arms with all partners. The difference in change across arms was of borderline significance for primary partner ( ); no difference was seen for nonprimary partner ( ). Use of male condom and FC increased with both partner types over time, but more consistently among I women. Conclusion: The ¡°value-added¡± impact of the intervention was observed mainly with primary partners. Body knowledge with routine FC counseling should be incorporated into interventions for drug-using women. 1. Introduction Women have among the highest rates of new HIV infections globally and the rate of new infections has not lessened in recent years [1¨C4]. African Americans account for 66% of new HIV infections among all US women [5]¡ªover 5 times their proportion representation (12%) in the population. One in 30 African-American women can expect to acquire HIV infection during their lifetime [6]; the vast majority of these are through heterosexual intercourse. Crack-using African-American women are a distinct, hard-to-reach population for whom empowerment to reduce HIV/STI risk takes on additional complexities due to the entangled dependencies of drugs, partnerships with men (who are often drug involved) for material support for women and their children, and constant threat of violent reprisal [4, 7¨C9]. Concurrent infection with STI is considered to be endemic among African-American, drug-using, HIV+ women [10]. Women¡¯s biological inequality in vulnerability to sexually transmitted infection (STI) can be addressed with greater availability and use of male and female condoms (FC). In addition to challenges in the diffusion of available protection technologies, however, gender
%U http://www.hindawi.com/journals/isrn.addiction/2013/768258/