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Reducing HIV and Partner Violence Risk Among Women with Criminal Justice System Involvement: A Randomized Controlled Trial of Two Motivational Interviewing-based Interventions

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Abstract

Women with histories of incarceration show high levels of risk for HIV and intimate partner violence (IPV). This randomized controlled trial with women at risk for HIV who had recent criminal justice system involvement (n = 530) evaluated two interventions based on Motivational Interviewing to reduce either HIV risk or HIV and IPV risk. Baseline and 3, 6, and 9-month follow-up assessments measured unprotected intercourse, needle sharing, and IPV. Generalized estimating equations revealed that the intervention groups had significant decreases in unprotected intercourse and needle sharing, and significantly greater reductions in the odds and incidence rates of unprotected intercourse compared to the control group. No significant differences were found in changes in IPV over time between the HIV and IPV group and the control group. Motivational Interviewing-based HIV prevention interventions delivered by county health department staff appear helpful in reducing HIV risk behavior for this population.

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Notes

  1. Women who were chronically homeless or at high risk for future homelessness were excluded because of the likelihood of limited intervention effectiveness and poor subject retention. Specifically, women currently housed were excluded if they had been homeless for three or more of the past six months and could not identify a future residence. Women who were currently homeless were excluded if they had been homeless for three or more of the past six months or could not identify a specific, future residence.

  2. ACASI was implemented to reduce costs and staff time associated with interview administration and data entry. One participant who received a baseline interviewer-administered baseline received an ACASI at one follow-up. Twelve participants who received baseline ACASI received an interviewer-administered follow-up assessment; eleven of these interviews were conducted in jail or prison where ACASI was not feasible.

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Acknowledgments

This research was supported by a grant from the National Institute on Drug Abuse (R01DA012572) and approved by the Oregon State Public Health/Multnomah County Public Health Institutional Review Board. The authors wish to thank David W. Fleming, Public Health—Seattle and King County, for early guidance on the study design and Stephanie Wahab, Portland State University, for reviewing the manuscript. We thank our community partners, staff of the Multnomah County Health Department HIV and Hepatitis C Community Prevention Programs, and our research participants.

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Authors and Affiliations

  1. Program Design & Evaluation Services, Oregon Department of Human Services, Portland, OR, USA

    Brian W. Weir

  2. Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, 624 N Broadway, Baltimore, MD, 21205, USA

    Brian W. Weir

  3. Department of Psychology, Portland State University, Portland, OR, USA

    Kerth O’Brien

  4. Program Design & Evaluation Services, Multnomah County Health Department, Portland, OR, USA

    Ronda S. Bard, Julie E. Maher, Clyde W. Dent, John A. Dougherty & Michael J. Stark

  5. Multnomah County HIV and Hepatitis C Community Programs, Multnomah County Health Department, Portland, OR, USA

    Carol J. Casciato

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  1. Brian W. Weir
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Correspondence to Brian W. Weir.

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Weir, B.W., O’Brien, K., Bard, R.S. et al. Reducing HIV and Partner Violence Risk Among Women with Criminal Justice System Involvement: A Randomized Controlled Trial of Two Motivational Interviewing-based Interventions. AIDS Behav 13, 509–522 (2009). https://doi.org/10.1007/s10461-008-9422-0

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