Active Drug-Using Women Use Female-Initiated Barrier Methods to Reduce HIV/STI Risk: Results from a Randomized Trial.

Area of Science:

• Public Health
• Behavioral Science
• HIV Prevention

Background:

• Active drug users are at high risk for HIV/STIs due to unprotected sex.
• Existing interventions need to address the specific needs of women, including empowerment and control over sexual health.
• Female-initiated barrier methods, like the female condom (FC), offer women greater autonomy.

Purpose of the Study:

• To evaluate a novel woman-focused intervention combining body empowerment and female-initiated barrier methods.
• To assess the intervention's impact on reducing unprotected vaginal intercourse among HIV-seronegative, active drug-using women.
• To compare the effectiveness of the intervention against enhanced HIV/STI harm reduction counseling alone.

Main Methods:

• A randomized controlled trial involving 198 women aged 18+ who reported high rates of unprotected sex.
• Intervention group received standard counseling plus 5 weekly group sessions focused on empowerment and female barrier methods.
• Control group received enhanced HIV/STI harm reduction counseling.

Main Results:

• Both groups showed significant reductions in unprotected sex, but the intervention group's reduction was more pronounced with primary partners.
• Female condom (FC) use increased in both groups, with more consistent increases observed among intervention participants.
• The intervention demonstrated a borderline significant "value-added" impact on reducing unprotected sex with primary partners.

Conclusions:

• The woman-focused intervention, emphasizing body knowledge and female condom (FC) use, showed a positive impact, especially with primary partners.
• Integrating body knowledge and routine FC counseling into interventions is recommended for drug-using women.
• Further research may explore optimizing these interventions for sustained behavioral change.