The Impact of Emotional Distress on HIV Risk Reduction Among Women

Abstract

This study evaluated whether 333 seronegative African American female drug users (aged 18–59 years) participating in an HIV intervention and with higher levels of emotional distress, specifically symptoms of depression and anxiety, reduced HIV risk behaviors to a lesser extent than those with lower levels of emotional distress. Participants were recruited between June 1998 and January 2001 from inner-city Atlanta (Georgia, U.S.) neighborhoods and were randomly assigned to one of two enhanced gender-specific and culturally specific HIV intervention conditions or to the NIDA standard condition. Participants were interviewed at baseline, post-intervention and at 6-month follow-up with a structured questionnaire including information on sociodemographics, sexual and drug-using behavior, and psychosocial characteristics. Despite a significant decline in symptoms of emotional distress during the study period, the women in this sample reported high levels of depressive and anxiety symptoms at baseline and 6-month follow-up. Higher levels of emotional distress were positively associated with post-intervention sexual and drug-taking risk. Women in both enhanced intervention conditions reduced their sexual and drug-taking risks more than women in the standard intervention. Those in the motivation intervention arm experienced a greater reduction in depressive symptoms, accompanied by a greater reduction in sexual risk behavior. Findings suggest the need for effective interventions and mental health resources among subgroups of high-risk women who may be most resistant to behavioral change.

Keywords:

• HIV intervention
• risk reduction
• emotional distress
• women
• drug use

Notes

¹Editor's note: The journal's style uses the category substance abuse as a diagnostic category. Substances are used or misused; living organisms are and can be abused.

²Income was difficult to assess in the present analysis. Qualitative data revealed that the women's income fluctuated greatly and that communicating weekly and yearly income was difficult for most respondents. Distinguishing between legal and illegal income (but not legal and illegal forms of employment or work) was also problematic. Therefore, we were uncomfortable with use of income in the present analysis.