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Washington University
School of Medicine
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Prevention of HIV and STDs in Drug Using
Women (WTW)
Abstract
Women Teaching Women (WTW) is proposed by a
team of Washington University investigators who have focused on HIV
prevention efforts among out-of-treatment injecting drug users (IDUs) and
crack cocaine users, since 1988. Our peer-delivered prevention model was
successful in reducing cocaine use among men. We believe no differences
were found in drug and sexual risk behaviors for women because the
intervention lacked gender-specificity. Thus, we propose to tailor our
previous intervention to women’s needs to determine the shorter and
intermediate term effectiveness of a gender-specific model on reducing
drug use and sexual risks. The urgency for women-focused interventions is
highlighted by increasing HIV/STD rates among women nationwide. The
intervention is designed to bring the HIV prevention message to women in a
public health environment. The three-arm intervention, which targets
out-of-treatment drug-using women, will assess the differential impact of
a woman-centered standard intervention alone, the same standard
intervention plus a well-woman exam, and those plus the addition of 4
educational sessions. This proposal responds to two NIDA PAs: 95-083
(Women’s HIV Risk and Protective Behaviors) and 96-018 (Drug Abuse
Prevention Intervention for Women and Minorities). Our risk reduction,
epidemiological and technology transfer aims include:
Risk Reduction Aims:
1. Recruit out-of-treatment female drug injectors, heroin,
crack/cocaine and methamphetamine users to into an intervention aimed at
reducing high risk sexual and drug use behaviors. Street outreach, bars
and clubs, shelters, health fairs and daycare facilities will be used to
reach these vulnerable women at risk.
2. Administer a modified theory-based, peer-delivered, gender and
culture-specific intervention that encourages women to reduce their high
risk drug and sexual behaviors. Women will be randomly assigned to one of
three peer-delivered interventions: a modified NIDA Cooperative Agreement
Standard Intervention (SI), the SI + Well-Woman Exam (SI+WWE), or the
SI+Well-Woman Exam + 4 Educational Sessions (SI+WWE+4ES). The Standard
Intervention will be delivered by peers; the Well-Woman Examination will
be conducted by a nurse practitioner; the four 2 hour educational sessions
will be conducted by peer facilitators from area drug treatment programs
paired with a community mental health or health professional.
3. Assess the effectiveness of the interventions in reducing drug
and sexual risk at 4 and 12 months post-intervention, controlling for
baseline characteristics.
4. Evaluate the relative cost-effectiveness of each intervention.
Epidemiologic Aim:
5. Assess: a) incidence of HIV, Hepatitis B and C, syphilis,
chlamydia and gonorrhea 12 months post-intervention; b) change in HIV risk
and drug and alcohol use at 4 and 12 months post-intervention; c) the
effect of psychopathology on behavior change at 12 months
post-intervention; d) lifetime history of substance abuse and service
utilization for mental and physical problems at baseline.
Technology Transfer Aim:
6. Disseminate findings to the scientific community, practitioners
and community members in formats that are appropriate, understandable, and
usable in order that the best possible women-centered intervention can be
developed for reducing HIV risk behaviors. We propose to create a WebSite
and present findings at local, national and international symposia.
Manuals describing the interventions will be developed and made available
to the field.
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Projects
National Monitoring of Adolescent Prescription Stimulants Study (N-MAPSS)
Prescription Drug Misuse,
Abuse and Dependence
Club Drug Use, Abuse, and Dependence
International Supplement
STD Supplement
Women
Teaching Women - (WTW)
Improving Treatment Services for Substance Abusers with Comorbid Depression
(SAD)
Sister
to Sister - (STS)
Nosology
Over-the-Counter Syringe Purchase in Four Communities
Analyses to Improve Reduction in Crack Use
Each
One Teach One - (EOTO)
Substance Abuse and Risk for AIDS - (SARA)
St.
Louis' Effort to Reduce the Spread of AIDS and IVDUs - (ERSA)
Community Based HIV Prevention Among Females at Risk in Bangalore INDIA
Deconstructing HIV Interventions Among Female Offenders
Enrolling and Retaining Female Offenders in HIV Trials
Collaborative MDMA and Other Club Drugs Study
Evaluating the Social Structure of a Local Heroin Market (NIDA-funded)
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Epidemiology and Prevention Research Group 
