Efficacy of a group-based multimedia HIV prevention intervention for drug-involved women under community supervision: project WORTH.
OBJECTIVE
This study is designed to address the need for evidence-based HIV/STI prevention approaches for drug-involved women under criminal justice community supervision.


OBJECTIVE
We tested the efficacy of a group-based traditional and multimedia HIV/STI prevention intervention (Project WORTH: Women on the Road to Health) among drug-involved women under community supervision.


METHODS
We randomized 306 women recruited from community supervision settings to receive either: (1) a four-session traditional group-based HIV/STI prevention intervention (traditional WORTH); (2) a four-session multimedia group-based HIV/STI prevention intervention that covered the same content as traditional WORTH but was delivered in a computerized format; or (3) a four-session group-based Wellness Promotion intervention that served as an attention control condition. The study examined whether the traditional or multimedia WORTH intervention was more efficacious in reducing risks when compared to Wellness Promotion; and whether multimedia WORTH was more efficacious in reducing risks when compared to traditional WORTH.


METHODS
Primary outcomes were assessed over the 12-month post-intervention period and included the number of unprotected sex acts, the proportion of protected sex acts, and consistent condom use. At baseline, 77% of participants reported unprotected vaginal or anal sex (n = 237) and 63% (n = 194) had multiple sex partners.


RESULTS
Women assigned to traditional or multimedia WORTH were significantly more likely than women assigned to the control condition to report an increase in the proportion of protected sex acts (β = 0.10; 95% CI = 0.02-0.18) and a decrease in the number of unprotected sex acts (IRR = 0.72; 95% CI = 0.57-0.90).


CONCLUSIONS
The promising effects of traditional and multimedia WORTH on increasing condom use and high participation rates suggest that WORTH may be scaled up to redress the concentrated epidemics of HIV/STIs among drug-involved women in the criminal justice system.


BACKGROUND
ClinicalTrials.gov NCT01784809.
Social Intervention Group, Columbia University, New York, New York, United States of America.
Nabila
N
El-Bassel
Social Intervention Group, Columbia University, New York, New York, United States of America.
Louisa
L
Gilbert
Social Intervention Group, Columbia University, New York, New York, United States of America.
Dawn
D
Goddard-Eckrich
Social Intervention Group, Columbia University, New York, New York, United States of America.
Mingway
M
Chang
Social Intervention Group, Columbia University, New York, New York, United States of America.
Elwin
E
Wu
Social Intervention Group, Columbia University, New York, New York, United States of America.
Tim
T
Hunt
School of Social Service Administration, University of Chicago, Chicago, Illinois, United States of America.
Matt
M
Epperson
Social Intervention Group, Columbia University, New York, New York, United States of America.
Stacey A
SA
Shaw
Columbia Center for New Media Teaching and Learning, New York, New York, United States of America.
Jessica
J
Rowe
Bronx Community Solutions, Center for Court Innovation, New York, New York, United States of America.
Maria
M
Almonte
Social Intervention Group, Columbia University, New York, New York, United States of America.
Susan
S
Witte
D000328:Adult; D055030:Drug Users; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000517:prevention & control*; D006801:Humans; D008875:Middle Aged; D019212:Multimedia; D011159:Population Surveillance; D012307:Risk Factors; D012725:Sexual Behavior; D012749:Sexually Transmitted Diseases / Q000453:epidemiology / Q000517:prevention & control