The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #62865

Wendee Wechsberg, PhD, Grace Hall, MPH, MPP, Winnie Luseno, MS, Wendy K.K. Lam, PhD, William A. Zule, DrPH, and Rachel Middlesteadt Ellerson, BS. Substance Abuse Treatment Evaluations and Interventions, Research Triangle Institute, PO Box 12194, 3040 Cornwallis Drive, Research Triangle Park, NC 27709-2194, 919-541-6422, wmw@rti.org

Social and environmental factors, such as low levels of education and limited job prospects, have led many South African women to become sex workers. Consequently, this population is an important target for HIV prevention efforts. To this end, a NIDA-funded, woman-focused HIV intervention found to be effective with African-American crack abusers in the US was adapted for Black South African sex workers. A small randomized field experiment tested the effectiveness of the intervention in Pretoria, South Africa. Ninety-three women were enrolled in the study and completed a baseline assessment. They were then randomized into either the woman-focused HIV intervention or the NIDA standard HIV intervention. Eighty-six percent completed a one-month follow-up. Overall, a decrease was observed from baseline to follow-up in the proportion of women who reported having unprotected sex with paying clients or boyfriends; with greater positive changes observed in the woman-focused group. While a substantial increase (from 28% to 55%) was observed in the woman-focused group in the proportion of women who reported using condoms with a boyfriend during their last sexual encounter, only a marginal change (from 44% to 48%) was observed in the standard condition. An overall decrease was also observed in the daily use of alcohol and cocaine, with the woman-focused group being less than half as likely to report daily alcohol use at follow-up (OR=0.46; 95% CI=0.07, 2.90) and slightly less likely to report daily cocaine use at follow-up (OR = 0.86; 95% CI=0.31, 2.43) than women in the standard group.

Learning Objectives:

• To promote process steps in adapting an intervention into another setting. To identify the specific HIV risks posed by women in South Africa that may be different than in the US.

Keywords: HIV Interventions, Women and HIV/AIDS

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.