UK Research Aims to Reduce Spread of HIV and Hepatitis in Rural Women

LEXINGTON, Ky. (Sept. 19, 2012) — Researchers at the University of Kentucky have embarked on a five-year study that aims to lower behavioral risks of HIV/AIDS and hepatitis C (HCV) among disadvantaged, rural women in Appalachian Kentucky.

Armed with a $2.7 million R01 grant from the National Institute on Drug Abuse (NIDA), the investigators will examine the effectiveness of a brief intervention in reducing high-risk behaviors, including sexual practices and injection drug use. 

Michele Staton-Tindall, associate professor in the UK College of Social Work, is the principal investigator. Co-investigators are Jennifer Havens, Carl Leukefeld and Matt Webster, in the Department of Behavioral Science, and Carrie Oser in the Department of Sociology.

"Our intervention will focus on an individualized plan for enhancing each woman's motivation to reduce risk behaviors and to utilize existing health services," Staton-Tindall said. "The long-term goal of this study is to increase access to health and behavioral-health services in order to improve the quality of health for high-risk rural women."

Hepatitis C has become a major threat to high-risk populations. Caused by a virus that attacks the liver, it is the leading cause of liver cancer in the United States. Currently, more Americans die each year from diseases related to hepatitis-C infection than from HIV-related causes, according to data from the Centers for Disease Control and Prevention. Like HIV, hepatitis C is spread through contact with contaminated blood, often through the use of needles shared by intravenous drug users.

"While the rates of HIV are low among Appalachian drug users, the same cannot be said for HCV," Havens said. "Dr. Staton-Tindall's intervention has the potential to have a significant impact among women at highest risk for HCV acquisition and transmission."

The project will incorporate standardized screening to identify high-risk rural women drug-users, including injectors, from jails in Eastern Kentucky. A total of 350 consenting women will be asked to participate in a baseline interview and will then be assigned randomly to one of two study groups.

Women in the first group will be tested for HIV and HCV, and they will receive the NIDA standard pre- and post-test counseling, as well as an information packet on existing community drug abuse and HIV/HCV resources.

Women in the second group will receive the same testing, counseling and information. In addition, these women will receive a brief intervention for high-risk women. The intervention utilizes an evidence-based technique known as motivational interviewing, "a collaborative conversation to strengthen a person’s own motivation for and commitment to change."

The women in the intervention group will meet with a counselor as many as four times, starting about a week before their release. Follow-up interviews will be conducted at three, six, and 12 months in the community post-release from jail.

“This is the first known study to capitalize on the real-world setting of rural jails as a location to provide outreach for an underserved population, rural drug using women, who are at high risk for HIV, HCV, and a lack of health care," Oser said.

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