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The intersection of substance abuse, poverty, low education level, unemployment, and homelessness contributes to health disparities and disease among minority women [1, 2]. In North Carolina, for example, African American women are disproportionately affected by human immunodeficiency virus (HIV) infection, compared with women of other races and ethnicities [3]. Building on a long history of research with out-of-treatment substance abusers at risk for HIV infection and the need for gender-focused research, the National Institute on Drug Abuse (NIDA) funded a project in 1998 that tested a woman-focused, culturally specific intervention for African American women who lived in the areas of Raleigh and Durham, North Carolina, and were using crack cocaine. The Centers for Disease Control and Prevention (CDC) evaluated this intervention, known as the Women’s CoOp [4], and determined it to be a “best-evidence” HIV behavioral prevention intervention [5]. The Women’s CoOp has been underway in North Carolina for more than 10 years, with follow-up of participants up to 7 years after enrollment [6].
