h i d f b i i ( )Comprehensive Women‐Centered Treatment for Substance Use in Georgia (country): Comprehensive Women Centered Treatment for Substance Use in Georgia (country):I iti l E i ti f D U d HIV i kInitial Examination of Drug Use and HIV risk g

Irma Kirtadze1 David Otiashvili1 Kevin O’Grady2 William Zule3 Evgeny Krupitsky4 Wendee Wechsberg3 Hendrée E Jones5,6Irma Kirtadze David Otiashvili Kevin O Grady William Zule Evgeny Krupitsky Wendee Wechsberg Hendrée E. Jones1Addiction Research Center, Alternative Georgia, Tbilisi, Georgia 2Department of Psychology, University of Maryland, College Park, MD 3 RTI International, Research Triangle Park, NC 27709, USA; 4Department of Addictions, Bekhterev Research PsychoneurologicalAddiction Research Center, Alternative Georgia, Tbilisi, Georgia Department of Psychology, University of Maryland, College Park, MD RTI International, Research Triangle Park, NC 27709, USA; Department of Addictions, Bekhterev Research Psychoneurological

Institute, St. Petersburg 192019, Russia 5UNC Horizons Program, Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514, USA; 6Departments of Psychiatry and Obstetrics and Gynecology, School of Medicine, Johns Hopkins University, Baltimore, MD 21224, USA;

Background Results (cont ) Results (cont )Background Results (cont.) Results (cont.)Drug use among women is hidden and highly stigmatized in Georgia. Although women represent up to Table 1. Basic participant information (N=128) Past 30-day sharing of needles and injection paraphernalia rarely occurred in the sample (M=1; SD=8.9),10% of the adult substance-using population only 1–5% of drug-related service beneficiaries are

I j ti d i th l di t f t i i f HIV Th b f h t llEthnicity N (%)G 11 (89%)

precluding inferential analyses. Figures 1, 2, 3 display rates of change past 30-day use of alcohol,i id d ti l t ti l P t 30 d f l h l h d th f th t i lwomen. Injection drug use is the leading route of transmission of HIV. The number of heterosexually

acquired HIV cases and number of newly infected women has been increasingGeorgians 114 (89%)Non-Georgians (other ethnic minorities) 14(11%)

opioids, and stimulants, respectively. Past 30-day use of alcohol changed over the course of the trial(p= 014) with use declining from baseline to post-treatment assessment and then rising back to baselineacquired HIV cases and number of newly infected women has been increasing. Non Georgians (other ethnic minorities) 14(11%)

Education(p=.014), with use declining from baseline to post-treatment assessment, and then rising back to baselinelevels at 3-month follow-up assessment. Past 30-day number of days of stimulant and opioid use

Methods 11 years school education 44 (34.37%)Student 4 (3 13%)

p y y pdeclined significantly from baseline to post-treatment, largely remain at post-treatment levels at 3-monthMethods Student 4 (3.13%)

University (uncompleted) 11 (8.59%) follow-up assessment (both ps < .001). The RBT+WC and UC conditions did differently change overf t t t i t f th i f b th ti l t d i id (b th 03) l l d tThe aim of this study was to develop a comprehensive women-centered intervention to reduce illicit

substance use and the rate of HIV infection among womenUniversity (completed) 67 (52.35%)Other 2(1 65%)

course of treatment in terms of their use of both stimulants and opioids (both ps < . 03), largely due tobaseline differencessubstance use and the rate of HIV infection among women.

The study design was a two arm randomized control trial that compared Reinforcement Based

Other 2(1.65%)Marital Status

baseline differences.

The study design was a two-arm randomized control trial that compared Reinforcement BasedTreatment (RBT) and Women’s CoOp (RBT+WC) to usual care (UC) The RBT+WC condition provided

Married to main sexual partner 38(29.68%)Li i ith i l t 30(23 44%) 3 5

Fig. 3  The change in stimulant use past 30 daysTreatment (RBT) and Women s CoOp (RBT+WC) to usual care (UC). The RBT+WC condition provideda structured 12-session intervention designed to reduce HIV/HCV risk and drug and alcohol use, and

Living with a main sexual partner 30(23.44%)Have a main sexual partner, but not living with him 56(43.75%) 3

3.5g g ,

improve mental and physical health, while the UC condition provided information booklets on the sameHave a main sexual partner, but not living with him 56(43.75%)No main sexual partner 4(3.13%) 2.5

3

topics as in the RBT+WC condition paired with case management for 12 sessions. Current Employment statusEmployed full time 6(4 69%)

25

RBT WCParticipants were 128 sexually active women who had injected illicit drugs in the 30 days prior to studyt U i d i d t d t h i d t 3 th f ll A i d i

Employed full-time 6(4.69%)Employed part-time 7(5.47%) 1.5 RBT+WC

UCentry. Urine drug screening was conducted at each session and at 3-month follow-up. A revised versionof the Risk Behavior Assessment (RRBA) developed for research in Russia served as the primary

y ( )Self-employed part-time 7(5.47%)Unemployed 105(82 03%) 0 5

1 UC

of the Risk Behavior Assessment (RRBA) developed for research in Russia served as the primaryoutcome measure (self-report questionnaire). Assessments were conducted at baseline, treatment

Unemployed 105(82.03%)Other 3 (2.34%) 0

0.5outcome measure (self report questionnaire). Assessments were conducted at baseline, treatmentcompletion, and 3-month following treatment entry.

( ) 0Baseline Post-treatment 3-month follow-upFig. 1 The change in alcohol use past 30 days p

6g g p y

C l iHypotheses 5

ConclusionC d t ti i t i th UC diti ti i t i th RBT+WC diti ill

yp4Compared to participants in the UC condition, participants in the RBT+WC condition will, on average,

show significant decreases in frequency of sharing syringes and other injection paraphernalia RBT+WC represents a promising comprehensive women centered intervention for reducing drug use and3 RBT+WCshow significant decreases in frequency of sharing syringes and other injection paraphernalia,frequency of use of opioids, stimulants and alcohol.

RBT+WC represents a promising comprehensive women-centered intervention for reducing drug use andpotentially HIV risks for substance-using women in Georgia2

3 RBT+WCUCq y p , potentially HIV risks for substance using women in Georgia.

1

2

ReferencesResults 0

1

References’ 1 (89%) f

0Baseline Post-treatment 3-month follow-up

Kirtadze, I., Otiashvili, D., O’Grady, K. E., Zule, W. A., Krupitsky, E. M., Wechsberg, W. M., & Jones, H. E., (2015). Women who Participants’ baseline characteristics are shown in Table 1. The vast majority (89%) of women reportedthat they were Georgian Age ranged from 20 to 64 years with a mean of 41 7 (SD=9 8) years; 67

ase e ost t eat e t 3 o t o o up

Fig. 2 The change in opioid use past 30 daysinject drugs in the Republic of Georgia: In their own words. Journal of Psychoactive Drugs, 2015, 7(1), 71-79.Jones, H. E., Kirtadze, I., Otiashvili, D., O’Grady, K. E., Murphy K., Zule, W. A., Krupitskii, E. M., & Wechsberg, W. M., Process

that they were Georgian. Age ranged from 20 to 64 years with a mean of 41.7 (SD=9.8) years; 67(52.35%) had 16 or more years of education (completed university or higher education). Approximately 14

g g p p y

, , , , , , y, , p y , , , p , , g, ,and product in cross-cultural treatment research: Development of a culturally sensitive women-centered substance use intervention in Georgia Journal of Addiction 2014 Article ID 163603

(52.35%) had 16 or more years of education (completed university or higher education). Approximately⅓ of the sample were married. The majority of participants were unemployed (82%); 52 women 12

intervention in Georgia. Journal of Addiction, 2014, Article ID 163603.AIDS clinical-immunological center (2015 statistics) http://www.aidscenter.ge/epidsituation_eng.html. Accessed 1 June 2015. (40.63%) responded that they live with someone who is using illicit drugs (including marijuana) or drinks 10J.Javakhishvili et al., 2015 Drug situation in Georgia 2013. Tbilisi, Georgia.alcohol. Average age of first drug use (excluding tobacco and alcohol) was 21.4 (SD=6.2), age of first

injection was 26 3 (SD=8 1) There were 113 participants who completed the study 68

RBT+WC

Acknowledgmentinjection was 26.3 (SD=8.1). There were 113 participants who completed the study.Figures 1 2 3 indicate number of episodes of past 30-day use of alcohol opioids and stimulants Past 4

6 CUC AcknowledgmentFigures 1, 2, 3 indicate number of episodes of past 30 day use of alcohol, opioids, and stimulants. Past

30-day sharing of needles and injection paraphernalia rarely occurred in the sample (M=1; 24

Supported by NIDA grant R01 DA029880 (Hendrée E. Jones, PI). NIDA played no role in: 1) study design;2) ll ti l i d i t t ti f d t 3) iti f th t 4) d i i t b it h

y g j p p y p (SD=8.9), precluding inferential analyses (data not shown). 0

2

2) collection, analysis, and interpretation of data; 3) writing of the report; or 4) decision to submit or whereto submit the poster for presentation Authors declare no conflict of interest

0Baseline Post-treatment 3-month follow-up to submit the poster for presentation. Authors declare no conflict of interest.