An experiential program to reduce AIDS risk among female sex partners of injection-drug users

Abstract

This article describes the development and implementation of an acquired immune deficiency syndrome (AIDS) intervention program for female sex partners of male injection-drug users. Four psychoeducational workshops were designed to motivate personal risk reduction, provide participants with necessary cognitive and behavioral skills, and enhance participants' perceived ability to enact positive changes in their lives. The development of the workshop modules was guided by traditional theories of health behavior change and social learning. Also included in the intervention are referral and advocacy services, personal risk reduction counseling, and human immunodeficiency virus (HIV) antibody testing. Preliminary results indicate that the program has made a significant impact on the AIDS risk of participants--91 percent of women who completed the program reported that they had made positive changes in their lives to reduce their risk of HIV infection.

PIP: Preliminary results of a psychoeducational program for the female sex partners of intravenous drug users suggest that this approach can motivate women to make behavioral changes that reduce their risk of human immunodeficiency virus (HIV) infection. Sexual contact with an intravenous drug user was identified, in 1991, as the primary risk factor in 4484 cases of acquired immunodeficiency syndrome (AIDS) in the US. The program was developed and implemented, on a pilot basis, by health and mental health professionals in Long Beach, California. Program components included risk reduction counseling, HIV antibody testing, referral for social and medical services, free condoms and bleach for cleaning needles, and participation in a series of 4 interactive workshops. By the end of the 3rd workshop session, participants are expected to make a personal commitment to reducing their risk of HIV infection, set specific short-term risk reduction goals, and articulate a plan for achieving them. In the 4th session, women practice partner negotiation skills and identify positive sources of social support. To date, 84 women have attended at least 1 workshop and 69 have completed all 4 sessions. The majority of participants were Black and Hispanic women on public assistance; although recruitment was limited to women who were not intravenous drug users, 40% were regular crack cocaine users. Interviews conducted with 53 participants immediately after the last workshop revealed numerous indicators of attitudinal and behavioral change. 91% indicated that the program had induced them to make changes in their life to reduce their HIV risk. All but 1 women had spoken with her male partner about stopping or reducing his drug use and 68% of women who had not used condoms before entering the program adopted condom use. 45% reported they had asked their male partner to mover out of the household and 15% had either moved out themselves or successfully evicted their partner due to his refusal to negotiate HIV risk reduction behaviors. Participants continue to receive case management services and have former informal support networks.