This three-arm cross-over randomized trial will develop, test, and compare the efficacy of two delivery formats of the Young Women's CoOp (YWC), which is designed to provide risk reduction and empowerment skills, as well as linkages to healthcare services for women who use substances. The current study will develop a revised version of the YWC and evaluate the relative efficacy of a face-to-face (face-to-face YWC), mobile Health application (mHealth YWC) delivery format, and HIV counseling and testing (HCT) as a control to reduce risky sexual behaviors and reduce substance use among young (18-25) African American women who use substances and are sexually active and have not recently been tested for HIV in three NC counties.
The purpose of this study is to use the seek, test, treat, and retain framework to develop and test the efficacy of a clinic-based, age-appropriate, woman-focused HIV risk-reduction intervention to reduce sexual risk among up to 700 young sexually active African American women aged 18 to 25 who use drugs in three North Carolina counties. The researchers will test the delivery of the woman-focused intervention conducted in two formats, face-to-face YWC and mHealth YWC, using a three-arm cross-over randomized design in which counties are randomized to (1) HCT as the control, (2) face-to-face YWC; and (3) mHealth YWC that will be delivered on tablets using an interactive app. The researchers will fulfill the purpose of this study through the following aims: (Aim 1) To develop a new YWC intervention and recruitment strategies using formative methods to engage young African American women who use substances and have not recently been tested for HIV, clinic staff, and stakeholders to ensure age appropriateness, to identify barriers to reaching these young women and the challenges in conducting the intervention in the clinics, and to develop the mHealth YWC; (Aim 2) To test the efficacy of two formats of the woman-focused intervention program (face-to-face YWC and mHealth YWC) relative to HCT with up to 700 young women aged 18 to 25 in three North Carolina county health departments for primary outcomes at 6-, and 12-month follow-up assessments; (Aim 3) To estimate the total costs of implementing the face-to-face YWC and mHealth YWC interventions, and to assess the resource components that drive these costs; and (Aim 4) To examine the extent to which the face-to-face YWC and mHealth YWC are perceived by collaborating health clinic staff and participants as being acceptable and sustainable.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
652
Participants will be offered HIV counseling and testing (HCT) and a two-session face-to-face YWC intervention. The face-to-face sessions will include information addressing the intersection of substance use, sexual risk, and violence through skill building, role-play, and rehearsal.
Participants will be offered HIV counseling and testing (HCT) and training on the mHealth application, which will include all content addressed in the face-to-face YWC delivery format. Participants will also be offered a tablet to complete the two-session intervention.
Participants will be offered standard HIV counseling and testing (HCT).
Durham County Department of Public Health
Durham, North Carolina, United States
Guilford County Department of Public Health - Greensboro
Greensboro, North Carolina, United States
Guilford County Department of Public Health - High Point
High Point, North Carolina, United States
Wake County Human Services
Raleigh, North Carolina, United States
Condomless Sex
Self-reported frequency of condomless sex
Time frame: Baseline
Condomless Sex
Self-reported frequency of condomless sex
Time frame: 6-month follow-up
Condomless Sex
Self-reported frequency of condomless sex
Time frame: 12-month follow-up
Frequency of Substance Use
Frequency of using illicit drugs and alcohol
Time frame: Baseline
Frequency of Substance Use
Frequency of using illicit drugs and alcohol
Time frame: 6-month follow-up
Frequency of Substance Use
Frequency of using illicit drugs and alcohol
Time frame: 12-month follow-up
Increased Sexual Negotiation
Self-reported ability to negotiate condom use and other safe sexual behavior with a male partner
Time frame: Baseline
Increased Sexual Negotiation
Self-reported ability to negotiate condom use and other safe sexual behavior with a male partner
Time frame: 6-month follow-up
Increased Sexual Negotiation
Self-reported ability to negotiate condom use and other safe sexual behavior with a male partner
Time frame: 12-month follow-up
Reduced Alcohol and Illicit Drug Use for a Subsample of Participants
Self-reported amount of alcohol consumption and drugs used; Urine drug screen will be used to test for recent illicit drug use; Breathalyzer test results will be used to assess recent alcohol use
Time frame: Baseline
Reduced Alcohol and Illicit Drug Use for a Subsample of Participants
Self-reported amount of alcohol consumption and drugs used; Urine drug screen will be used to test for recent illicit drug use; Breathalyzer test results will be used to assess recent alcohol use
Time frame: 6-month follow-up
Reduced Alcohol and Illicit Drug Use for a Subsample of Participants
Self-reported amount of alcohol consumption and drugs used; Urine drug screen will be used to test for recent illicit drug use; Breathalyzer test results will be used to assess recent alcohol use
Time frame: 12-month follow-up
Reduced Violence and Victimization for a Subsample of Participants
Self-reported experiences of emotional, physical, and sexual abuse
Time frame: Baseline
Reduced Violence and Victimization for a Subsample of Participants
Self-reported experiences of emotional, physical, and sexual abuse
Time frame: 6-month follow-up
Reduced Violence and Victimization for a Subsample of Participants
Self-reported experiences of emotional, physical, and sexual abuse
Time frame: 12-month follow-up
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