Substance Use, Sexual Risk, and Violence: HIV Prevention Intervention with Sex Workers in Pretoria
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This paper describes an HIV prevention intervention designed in the US that was adapted and implemented in South Africa. Using an experimental design, 93 women who reported recent substance use and sex trading were randomly assigned to a modified Standard HIV intervention or to a Woman-Focused HIV prevention intervention. Eighty women completed the one-month follow-up interview. Participants reported high rates of sexual risk and violence at baseline. At follow-up, findings showed decreases in the proportion of women reporting unprotected sex and the daily use of alcohol and cocaine. Daily alcohol and cocaine use decreased more for women receiving the Woman-Focused intervention. Although violence continued to be a problem, at follow-up Woman-Focused participants reported being victimized less often than women receiving the Standard intervention. This study demonstrates the feasibility of implementing cross-cultural behavioral HIV prevention interventions, and supports the need for future studies of women's contextual issues and the effectiveness of targeted interventions.
KEY WORDS:HIV prevention sexual health risks substance use behavioral interventions South Africa.
We wish to acknowledge the financial support provided by the National Institute on Drug Abuse (NIDA) grant R01 DA11609. We thank Dionne Jones (NIDA project officer), Grace Hall, Kara Riehman, Teri Swezey, William Zule, and Jeff Novey of RTI for helpful comments. We also wish to thank all the women participants, field staff, and community advisory board members for their involvement in this study.
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