Brief Intervention for Rural Women at High Risk for HIV/HCV

Specific Aim 1: Compare the effectiveness of an evidence-based HIV risk reduction intervention (MI-HIV) to HIV Education (NIDA Standard) in reducing sex risk behaviors, injection practices, and drug use among a culturally unique sample of disadvantaged, drug-using rural women at high-risk for HIV and HCV. This aim will be accomplished through the random selection of high-risk rural women drug users from rural jails, screening and assessment for high-risk behavior, and random assignment to the HIV-Ed or MI-HIV intervention conditions. Follow-up interviews at 3, 6, and 12 months in the community post-release will examine changes in high-risk behavior. It is expected that MI-HIV participants will report significantly greater reductions in risky injection drug use practices, other drug use, and sex risk behaviors than women who participate in the HIV-Ed condition.

Specific Aim 2: Examine MI-HIV Intervention engagement as a predictor of community health and behavioral health service utilization (including drug treatment and mental health) at follow-up among disadvantaged, drug-using rural women at high risk for HIV and HCV. This aim will focus on community service utilization during the follow-up period by the intervention and education comparison group, and how health and behavioral health service utilization relates to patterns of HIV/HCV risk behavior. It is expected that MI-HIV participants will utilize more services due to increased motivation for treatment and treatment planning following the brief intervention.

Inclusion criteria

• ASSIST score of 4+
• engagement in at least one sex risk behavior in the past 3 months
• willingness to participate in brief intervention sessions
• no evidence of cognitive impairment
• no evidence of active psychosis (currently experiencing hallucinations)
• no self-reported current symptoms of physical withdrawal from a recent episode of drug use
• incarceration period of 1 week - 3 months in order to complete intervention sessions

Exclusion criteria

• ASSIST score of <4
• no engagement in at least one sex risk behavior in the past 3 months
• not willing to participate in brief intervention sessions
• evidence of cognitive impairment
• evidence of active psychosis (currently experiencing hallucinations)
• self-reported current symptoms of physical withdrawal from a recent episode of drug use
• incarceration period of less than 1 week or greater than 3 months in order to complete intervention sessions