Sustainability of intervention effects of an evidence-based HIV prevention intervention for African American women who smoke crack cocaine.
BACKGROUND
HIV prevention intervention efficacy is often assessed in the short term. Thus, we conducted a long-term (mean 4.4 years) follow-up of a woman-focused HIV intervention for African American crack smokers, for which we had previously observed beneficial short-term gains.


METHODS
455 out-of-treatment African American women in central North Carolina participated in a randomized field experiment and were followed up to determine sustainability of intervention effects across three conditions: the woman-focused intervention, a modified NIDA intervention, and a delayed-treatment control condition. We compared these groups in terms of HIV risk behavior at short-term follow-up (STFU; 3-6 months) and long-term follow-up (LTFU; average 4 years).


RESULTS
The analyses revealed two distinct groups at STFU: women who either eliminated or greatly reduced their risk behaviors (low-risk class) and women who retained high levels of risk across multiple risk domains (high-risk class). At STFU, women in the woman-focused intervention were more likely to be in the low HIV risk group than the women in control conditions, but this effect was not statistically significant at LTFU. However, low-risk participants at STFU were less likely to be retained at LTFU, and this retention rate was lowest among women in the woman-focused intervention.


CONCLUSIONS
Short-term intervention effects were not observed over 4 years later, possibly due to differential retention across conditions. The retention of the highest risk women presents an opportunity to extend intervention effects through booster sessions for these women.
Wechsberg
Wendee M
WM
RTI International,, Substance Abuse Treatment Evaluations and Interventions, 3040 Cornwallis Road, Research Triangle Park, NC 27709-2194 USA. wmw@rti.org
Novak
Scott P
SP
Zule
William A
WA
Browne
Felicia A
FA
Kral
Alex H
AH
Ellerson
Rachel Middlesteadt
RM
Kline
Tracy
T
D000293:Adolescent; D000328:Adult; D001741:Black or African American; D000428:Alcohol Drinking / Q000453:epidemiology; D001007:Anxiety / Q000150:complications / Q000523:psychology; D019970:Cocaine-Related Disorders / Q000150:complications*; D016578:Crack Cocaine; D003866:Depressive Disorder / Q000150:complications / Q000523:psychology; D004651:Employment; D019317:Evidence-Based Medicine; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000150:complications* / Q000517:prevention & control*; D006703:Ill-Housed Persons; D006801:Humans; D008875:Middle Aged; D009657:North Carolina / Q000453:epidemiology; D010352:Patient Dropouts; D011237:Predictive Value of Tests; D012307:Risk Factors; D012959:Socioeconomic Factors; D016896:Treatment Outcome; D047568:Unsafe Sex; D055815:Young Adult
D016578:Crack Cocaine