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Women Protecting Women: Case Management Alternatives for African-American Women at High Risk for HIV

Hilary L. Surratt, Principal Investigator
Steven P. Kurtz, Co-Investigator

Project Period: 2006-2013
Funding Amount: $2.9 Million
Funding Source: National Institute on Drug Abuse

Project Summary:

The second phase of the Women Protecting Women project was designed to test innovative case management approaches for increasing linkages and engagement with drug abuse treatment, HIV-related care, and other health services among an underserved population of drug-using African American women sex workers. In this regard, the study enrolled and randomized 562 women sex workers to one of two alternative case management conditions. The Specific Aims of the study were to:

  1. Assess the nature and extent of mental, physical, and other health and social service needs and barriers to “service linkage” and “engagement” among a sample of 550 drug-involved, indigent, African-American women sex workers/exchangers recruited from inner city neighborhoods in downtown Miami, Florida.
  2. Implement two robust case management conditions designed to increase service linkages and engagement with appropriate drug abuse treatment and other health and social services in the Miami area by randomly assigning participants to:
    • a 5-session Strengths-Based / Professional-Only (PO) Condition in which clients participate in a “strengths-based” case management approach with an experienced, professional case manager who partners with the client to set, plan, and achieve goals from a strengths perspective; or,
    • a 5-session Strengths-Based / Professional-Peer (PP) Condition in which a team composed of: a) an experienced, professional case manager, and b) a former sex worker/recovering addict working as a peer facilitator – both trained in “strengths-based” case management techniques -- actively work with the client to develop service goals, facilitate implementation of the case plan, as well as assist the client in overcoming obstacles to service access.
  3. Evaluate the relative effectiveness of the interventions by conducting 3- and 6-month follow-ups with both clients and providers to determine the extent of service linkages and engagement, as well as lifestyle changes as they relate to increases in service utilization (reductions in drug use, HIV risk behaviors, sex work, homelessness, victimization).
  4. Both across and between the two conditions, assess the patterns of interaction among predisposing, enabling, and illness/need factors described by the Andersen Model of health services utilization, and examine their effects on services linkage and engagement at follow-up.



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