An Effective HIV Risk Reduction Protocol for Drug-Using Women Sex Workers

HIV prevention is an especially salient issue for women, given the ongoing feminization of the epidemic. Female sex workers are especially vulnerable to HIV infection, particularly those who are drug-using and engage in street-based sex exchange. This paper examines risk behaviors and HIV serostatus of 806 drug-using women sex workers in Miami, Florida, and assesses the relative impact of two HIV and hepatitis prevention interventions on changes in risk behavior. Drug-using sex workers were recruited using targeted sampling strategies and were randomly assigned to one of two intervention conditions – the NIDA Standard, or an innovative Sex-Worker Focused (SWF) intervention. Interview data were collected pre-intervention and 3 and 6 months post-intervention, and blood samples were collected for HIV and hepatitis B and C testing. Overall, 21% of the sample tested HIV positive. Outcome analyses indicate that both groups benefited from participation in the intervention trial. However, the SWF intervention was found to be more efficacious with reductions in unprotected oral sex, and sexual violence. These data support the importance of HIV testing and intervention programs for drug-using women sex workers.