Date of Completion


Embargo Period



Valerie Duffy ,Tania B. Huedo-Medina

Field of Study

Allied Health


Master of Science

Open Access

Open Access


Background and Objective: Unsafe needle use and unprotected sex are behaviors that have been associated with HIV transmission. Evidence-based behavioral intervention approaches are widely available for preventing HIV transmission, but neurocognitive impairment (NCI) may impede many intervention participants’ capacity to fully benefit from such interventions, leaving them vulnerable to HIV transmission risk. This study examines the impact of NCI on specific intervention outcomes expected to be enhanced through intervention participation.

Methods: Participants were 74 HIV+ opioid-dependent persons participating in methadone maintenance drug treatment and who reported drug- or sex- related HIV risk behavior. Using regression analyses, NCI, HIV knowledge (information), motivation, and intervention group assignment were used to predict changes in needle cleaning skills, male condom application skills, and female condom application skills.

Results:Intervention group assignment significantly predicted improvement in demonstrated needle cleaning skills and female condom application skills. HIV knowledge (Information) significantly predicted improvement in needle cleaning skills (p

Conclusion: Because the assigned intervention group significantly influenced needle cleaning skills and female condom application skills, our results indicate that the 3H+ intervention was related to greater levels of improvement in these areas. Because HIV knowledge (Information) significantly predicted improvements in needle cleaning skills and female condom application skills, continuing to target participants’ specific knowledge about HIV is indicated. Though NCI and motivation were not found to be significant predictors of outcomes, some of the patterns were in the predicted direction, and were likely impacted by relatively low statistical power.

Major Advisor

Michael Copenhaver

Available for download on Sunday, December 14, 2025