title: The impact of emotional distress on HIV risk reduction among women.
abstract: This study evaluated whether 333 seronegative African American female drug users (aged 18-59 years) participating in an HIV intervention and with higher levels of emotional distress, specifically symptoms of depression and anxiety, reduced HIV risk behaviors to a lesser extent than those with lower levels of emotional distress. Participants were recruited between June 1998 and January 2001 from inner-city Atlanta (Georgia, U.S.) neighborhoods and were randomly assigned to one of two enhanced gender-specific and culturally specific HIV intervention conditions or to the NIDA standard condition. Participants were interviewed at baseline, post-intervention and at 6-month follow-up with a structured questionnaire including information on sociodemographics, sexual and drug-using behavior, and psychosocial characteristics. Despite a significant decline in symptoms of emotional distress during the study period, the women in this sample reported high levels of depressive and anxiety symptoms at baseline and 6-month follow-up. Higher levels of emotional distress were positively associated with post-intervention sexual and drug-taking risk. Women in both enhanced intervention conditions reduced their sexual and drug-taking risks more than women in the standard intervention. Those in the motivation intervention arm experienced a greater reduction in depressive symptoms, accompanied by a greater reduction in sexual risk behavior. Findings suggest the need for effective interventions and mental health resources among subgroups of high-risk women who may be most resistant to behavioral change.
authors.affiliation: Department of Behavioral Sciences and Health Education, Emory University Rollins School of Public Health, Atlanta, Georgia 30322, USA. csterk@sph.emory.edu
authors.forename: Claire E
authors.initials: CE
authors.lastname: Sterk
authors.forename: Katherine P
authors.initials: KP
authors.lastname: Theall
authors.forename: Kirk W
authors.initials: KW
authors.lastname: Elifson
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005845:Georgia; D015658:HIV Infections / Q000517:prevention & control*; D006801:Humans; D008875:Middle Aged; D040242:Risk Reduction Behavior; D013315:Stress, Psychological; D019966:Substance-Related Disorders; D011795:Surveys and Questionnaires