Reducing Risky Sex among Rural African American Cocaine Users: A Controlled Trial

Area of Science:

• Public Health
• Behavioral Science
• Infectious Disease Epidemiology

Background:

• Rural African American cocaine users face disproportionately high rates of sexually transmitted infections (STIs) and HIV.
• Effective risk reduction strategies are crucial for this vulnerable population.

Purpose of the Study:

• To evaluate an adapted evidence-based risk reduction program for rural African American cocaine users.
• To assess the program's impact on sexual risk behaviors, condom use, and negotiation skills.

Main Methods:

• A NIDA-funded trial involving 251 African American cocaine users in rural Arkansas (2009-2011).
• Comparison of an adapted risk reduction program against an active control condition.
• Outcomes measured included condom use skills, self-efficacy, sexual negotiation skills, peer norms, and self-reported risk behaviors.

Main Results:

• The intervention group showed greater improvements in condom use skills and sexual negotiation effectiveness.
• Both groups reported reductions in trading sex and increased use of specific negotiation skills.
• Improvements in condom use self-efficacy were observed in both intervention and control groups.

Conclusions:

• The adapted risk reduction program demonstrates efficacy in enhancing sexual risk reduction skills among rural African American cocaine users.
• Findings highlight the importance of tailored, evidence-based interventions for high-risk populations to mitigate STI/HIV transmission.
• Further research should explore long-term behavioral impacts and broader implementation strategies.