Adapting an evidence-based HIV prevention intervention for pregnant African-American women in substance abuse treatment

Figures & data

Table 1 Examples of the voices of women filmed and issues they faced as part of the vignettes

Drug risks during pregnancy	“When I found out I was pregnant with my last baby … I said, Lord what have I done? That baby is going to come out addicted to drugs.”
Treatment need	“It is so much not worth it. The high might be great. That, but when you look back … oh my one second, that 5-minute high. God, you see the whole mess of trail that you’ve made. It’s unreal. I’d say, get help. Get help, let someone help you. Just pick yourself up and try again. Don’t stay there. You know how they say you fall and don’t get up. It’s OK to fall but get back up.”
Victimization	“Because he knew I was pregnant, he seemed to beat on me more. As a result of the beatings and as a result of the violence, what happened was I ended up miscarrying that child ….”

Table 2 Overview of intervention sessions

Session 1

– Welcome and introductions

– Being healthy and pregnant

– Beginning this process: 5 Rs for risk reduction

– Staying in treatment

– Drug risks during pregnancy

– Benefits of substance abuse treatment

– The bottom line

– Action plan

Session 2

– HIV among African-American women in NC

– What is HIV?

– Other sexually transmitted infections (STIs)

– How can untreated STIs affect a woman and her baby?

– Importance of using protection

– How to use male and female condoms

– Healthy vaginal practices

– Oral sex

– Sex trading and “taking care of business”

– Injecting drug users (if applicable)

– Talking about safer sex

– Negotiation and effective refusal

– Stay alert, stay powerful

– Action plan

Session 3

– Substance use and relationships

– Victimization and abuse

– Violence prevention

– Staying safe

– Know your rights and don’t give up

– Physical effects of violence during pregnancy

– Prenatal care

– HIV test

– Action plan

Session 4

– The HIV test – reminders

– Understanding relapse

– Benefits of a drug-free life

– Suggestions for building a sister-to-sister network

– Building your personal power and confidence

– Summary: 5 Rs for risk reduction

– Community resources for women

– Substance abuse keeps you oppressed – empowering yourself

– Assertive and powerful women

– Action plan

Session 5 (for HIV+ women)

– Being HIV+ and pregnant

– How HIV affects the immune system

– Factors that may increase the risk of mother-to-child transmission

– Is breastfeeding best … not necessarily

– Anti-HIV drugs – protect you and baby

– Viral load and CD4 count

– Adherence and drug resistance

– Anti-HIV drug safety

– Hepatitis C

– Tuberculosis^2323

– Good nutrition

– What type of medical follow-up should you consider?

– Action plan

Table 3 Study baseline sample characteristics (N = 59)

Self-reported characteristic	Statistic
Sociodemographic data
Age, mean (SD)	28.7 (6.6) median = 28
Relationship status
Not currently involved with a sex partner	44.1%
Involved but not living with a main sex partner	37.3%
Involved and living with a main sex partner	18.6%
Completed 12th grade or above	42.4%
No. of weeks gestation, mean (SD)	24.0 (6.5)
Current pregnancy not planned	91.4%
No. of times previously pregnant, mean (SD)	3.1 (2.3) Range: 0–8
Have been physically hurt by someone since pregnant	15.3%
Used any drugs since found out was pregnant	69.5%
Employment status
Unemployed	76.3%
Working part time or full time	8.5%
Currently homeless	40.7%

Note: No significant differences were found between the intervention and treatment-as-usual groups on the variables presented.

Table 4 Self-reported drug use and sexual risk in the past 90 days

Self-reported characteristic	Statistic
Substance use in the past 90 days
Tobacco	74.6%
Marijuana	50.8%
Crack	52.5%
Alcohol	42.4%
Sexual risk in the past 90 days
No. of sex partners, mean (SD)	8.0 (36.8)
No. of unprotected vaginal and/or anal sex acts with main partner, mean (SD)	16.6 (24.4)
Sex trading	38.5%

Note: No significant differences were found between the intervention and treatment-as-usual groups on the variables presented.