Feasibility and initial efficacy of a culturally sensitive women-centered substance use intervention in Georgia: Sex risk outcomes

Hendrée E. Jones, Irma Kirtadze, David Otiashvili, Keryn Murphy, Kevin E. O'Grady, William Zule, Evgeny Krupitsky, Wendee M. Wechsberg

Research output: Contribution to journalArticle

Abstract

Background: This paper reports on the feasibility and initial efficacy of a culturally sensitive, comprehensive women-centered substance use intervention for women who inject drugs in Georgia in terms of the primary and secondary sex risk outcomes. The hypothesis under examination was that, relative to case management participants, participants in a culturally sensitive, comprehensive women-specific and -centered intervention would, on average, show significant decreases in past-30-day frequency of unprotected sex, unprotected sex at the last sexual encounter, and increases in condom use and safer sex actions. Methods: The study was a two-arm randomized trial, in which 173 potentially eligible women were screened, and those 128 women determined to be eligible were assigned at random to either Reinforcement-based Treatment plus Women's Co-Op (RBT + WC) or case management (CM). RBT + WC participants received 12 sessions of a structured intervention with the goal of reducing risky sex and substance use and improving physical and mental health. CM participants received 12 sessions of case management and informational brochures that focused on the same issues on which RBT + WC focused. Participants were assessed at baseline, post-treatment, and 3 months following treatment enrollment. Results: Analyses revealed case management having significantly overall higher Safer Sex action scores than RBT + WC, and a significant decrease over time for past 30-day number of unprotected sex acts. Unprotected sex at the last encounter and Condom Use action scores were nonsignificant. Conclusions: Women who inject drugs in Georgia are engaging in risky sexual practices, and are in need of an intervention that addresses these risky behaviors. Reasons for the failure to find differences between a culturally sensitive, comprehensive women-centered intervention and case management tailored to the needs of women who inject drugs in Georgia may have been the result of inadequate power to detect an effect in a sample whose drug use was not as serious as warranted by the intervention. (ClinicalTrials.gov Identifier: NCT01331460)

Original languageEnglish (US)
JournalSubstance Abuse: Treatment, Prevention, and Policy
DOIs
StateAccepted/In press - Dec 8 2015

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Case Management
Unsafe Sex
Safe Sex
Condoms
Pharmaceutical Preparations
Pamphlets
Mental Health
Therapeutics

Keywords

  • Georgia
  • HIV prevention
  • Injection drug use
  • Risky sexual behavior
  • Women-centered treatment

ASJC Scopus subject areas

  • Health Policy
  • Psychiatry and Mental health

Cite this

Feasibility and initial efficacy of a culturally sensitive women-centered substance use intervention in Georgia : Sex risk outcomes. / Jones, Hendrée E.; Kirtadze, Irma; Otiashvili, David; Murphy, Keryn; O'Grady, Kevin E.; Zule, William; Krupitsky, Evgeny; Wechsberg, Wendee M.

In: Substance Abuse: Treatment, Prevention, and Policy, 08.12.2015.

Research output: Contribution to journalArticle

Jones, Hendrée E. ; Kirtadze, Irma ; Otiashvili, David ; Murphy, Keryn ; O'Grady, Kevin E. ; Zule, William ; Krupitsky, Evgeny ; Wechsberg, Wendee M. / Feasibility and initial efficacy of a culturally sensitive women-centered substance use intervention in Georgia : Sex risk outcomes. In: Substance Abuse: Treatment, Prevention, and Policy. 2015.
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abstract = "Background: This paper reports on the feasibility and initial efficacy of a culturally sensitive, comprehensive women-centered substance use intervention for women who inject drugs in Georgia in terms of the primary and secondary sex risk outcomes. The hypothesis under examination was that, relative to case management participants, participants in a culturally sensitive, comprehensive women-specific and -centered intervention would, on average, show significant decreases in past-30-day frequency of unprotected sex, unprotected sex at the last sexual encounter, and increases in condom use and safer sex actions. Methods: The study was a two-arm randomized trial, in which 173 potentially eligible women were screened, and those 128 women determined to be eligible were assigned at random to either Reinforcement-based Treatment plus Women's Co-Op (RBT + WC) or case management (CM). RBT + WC participants received 12 sessions of a structured intervention with the goal of reducing risky sex and substance use and improving physical and mental health. CM participants received 12 sessions of case management and informational brochures that focused on the same issues on which RBT + WC focused. Participants were assessed at baseline, post-treatment, and 3 months following treatment enrollment. Results: Analyses revealed case management having significantly overall higher Safer Sex action scores than RBT + WC, and a significant decrease over time for past 30-day number of unprotected sex acts. Unprotected sex at the last encounter and Condom Use action scores were nonsignificant. Conclusions: Women who inject drugs in Georgia are engaging in risky sexual practices, and are in need of an intervention that addresses these risky behaviors. Reasons for the failure to find differences between a culturally sensitive, comprehensive women-centered intervention and case management tailored to the needs of women who inject drugs in Georgia may have been the result of inadequate power to detect an effect in a sample whose drug use was not as serious as warranted by the intervention. (ClinicalTrials.gov Identifier: NCT01331460)",
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AU - Murphy, Keryn

AU - O'Grady, Kevin E.

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AU - Krupitsky, Evgeny

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