title: Sustainability of intervention effects of an evidence-based HIV prevention intervention for African American women who smoke crack cocaine.
abstract: 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.
authors.affiliation: RTI International,, Substance Abuse Treatment Evaluations and Interventions, 3040 Cornwallis Road, Research Triangle Park, NC 27709-2194 USA. wmw@rti.org
authors.forename: Wendee M
authors.initials: WM
authors.lastname: Wechsberg
authors.forename: Scott P
authors.initials: SP
authors.lastname: Novak
authors.forename: William A
authors.initials: WA
authors.lastname: Zule
authors.forename: Felicia A
authors.initials: FA
authors.lastname: Browne
authors.forename: Alex H
authors.initials: AH
authors.lastname: Kral
authors.forename: Rachel Middlesteadt
authors.initials: RM
authors.lastname: Ellerson
authors.forename: Tracy
authors.initials: T
authors.lastname: Kline
mesh_terms: 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
chemical_list: D016578:Crack Cocaine