Reduction of Co-Occurring Distress and HIV Risk Behaviors Among Women Substance Abusers

Abstract

SUMMARY Women who abuse alcohol and drugs may have a number of co-occurring distress issues, such as depression, traumatic stress, and violence, that impede their ability to make changes in the behaviors that place them at risk for contracting HIV. The objective of this article is to evaluate the influence of participating in an enhanced HIV risk-reduction project on reducing women's co-occurring distress. Study participants were 206 predominantly African-American women who participated in the North Carolina CoOperative (NC CoOp) Study that provided AIDS outreach to crack and injection drug users. The women participated in a two-session standard risk-reduction intervention and were then randomly assigned to either receive no further intervention or to participate in an additional three-session-enhanced intervention. The enhanced intervention was designed to work with individual participants in the context of their specific needs and co-occurring distress issues. Co-occurring distress, including depression, anxiety, traumatic stress, victimization, aggression, and physical health, was measured at intake and at 3 months after the intervention. The reduction in co-occurring distress was much more substantial for participants receiving the enhanced intervention. In addition, the difference in reduction of co-occurring distress between the standard and enhanced intervention groups was the greatest for women who reported the highest levels of baseline co-occurring distress. These findings suggest that a longer, more personalized intervention may be expected to produce greater positive changes in the lives of women who exhibit a high degree of distress. Reduction in co-occurring distress can improve women's quality-of-life and may enhance their ability to subsequently reduce their HIV risk behavior.