Who’s getting the message? intervention response rates among women who inject drugs and/or smoke crack cocaine

Background Injection drug users (IDUs) who also smoke crack may be at greatest risk for infection with HIV as well as other blood-borne and sexually transmitted infections and in most need of positive behavioral changes. Methods Three hundred and thirty-three women (aged 18–59 years) were randomly assigned to one of two enhanced gender- and culturally specific HIV intervention conditions or to the NIDA standard condition. Of primary interest in this study were baseline risk and intervention response rates among three groups of drug users—IDUs who did not smoke crack, IDUs who did smoke crack, and crack smokers who did not inject. Univariate and multivariate methods were utilized, including generalized estimating equations. Results The intervention produced positive behavioral changes over time, but response rates varied according to drug using group. Overall, women falling into the crack smoking IDU category appeared to be less responsive to the intervention than those in the other drug using groups, and participants in the crack smoking only group were less responsive than those in the IDU only group. Conclusions Results presented here indicate the continuing need to develop and target effective interventions to particular subgroups of high-risk individuals who may be most resistant to change.