title: Integrated HIV care: HIV risk outcomes of pregnant substance abusers.
abstract: Identifying contextual factors that may influence the effects of HIV risk-reduction strategies aimed at inner-city, minority female populations may be critical to interrupting the alarming trends in seroprevalence in the United States, especially among pregnant women with substance use-related problems. The objective of this Phase I, NIDA-funded project was to determine which contextual and cognitive factors were most predictive of HIV outcomes in this population. Eighty-one HIV-negative women were enrolled in a maternal addiction program with a cognitive-behavioral HIV risk-reduction component. Measures were administered between 1996 and 1998, one week post-admission, and follow-up assessments were conducted on 69 participants at 6 months post-discharge Paired t-tests were conducted to assess changes in sex risk behaviors, HIV/AIDS-related knowledge, and HIV risk-related attitudes/behaviors. Hierarchical regression analyses were conducted to investigate the relationship between attitudes/knowledge with contextual variables. At six months follow-up, there were significant increases in favorable condom attitudes (t = 3.36, p = .01) and in factual knowledge regarding HIV (t = 3.20, p = .01), with a significant decrease in the number of sexual partners (t = 2.21, p = .05). Hierarchical regression analysis revealed that the strongest predictors of the number of partners--a key outcome variable--were alcohol use, intentions to engage in safer sex behaviors, psychiatric symptoms, and a history of physical abuse (F[11, 57] = 6.58, p < .001). This study also reinforces the strategic importance of utilizing substance user treatment programs as crucial vehicles for integrating HIV risk-reduction strategies. Additionally, it will further guide the design of effective procedures to test the feasibility of an integrated HIV risk-reduction intervention for a larger randomized controlled study. The study's limitations are noted.
authors.affiliation: Florida International University, Miami, Florida 33181, USA. rmalow@bellsouth.net
authors.forename: Robert M
authors.initials: RM
authors.lastname: Malow
authors.forename: Jessy G
authors.initials: JG
authors.lastname: Dévieux
authors.forename: Rhonda
authors.initials: R
authors.lastname: Rosenberg
authors.forename: Janyce G
authors.initials: JG
authors.lastname: Dyer
authors.forename: Janet S
authors.initials: JS
authors.lastname: St Lawrence
mesh_terms: D000293:Adolescent; D000328:Adult; D001294:Attitude to Health; D015928:Cognitive Behavioral Therapy; D005260:Female; D005431:Florida; D015658:HIV Infections / Q000517:prevention & control*; D006801:Humans; D008913:Minority Groups; D017063:Outcome Assessment, Health Care; D011247:Pregnancy; D040242:Risk Reduction Behavior; D019966:Substance-Related Disorders