The purpose of this renewal application is to continue our efforts to impact the behaviors that place injection drug users (IDUs) at risk for HIV infection. Beginning in 1987, we conducted community-based interventions with IDUs in Denver to prevent HIV infection using the Indigenous Leader Outreach Model. The model focused on promoting the alteration or elimination of specific behaviors that place IDUs at risk for infection. While significant reductions in HIV risk-related behaviors occurred, many IDUs remained at risk. In an effort to extend our intervention message beyond safer injection practices, in 1995 we initiated an intervention designed to encourage IDUs to enter treatment for their drug addiction and quit their use of drugs. The intervention, based on the principals of motivational interviewing (MI), focused on moving IDUs along the 'stages of change' continuum. Although more than 40% of those we have intervened with to date entered treatment, we feel we can improve our efforts to achieve abstinence by increasing the time allotted to motivate more resistant IDUs and by addressing the multiple needs they have that impede their desire to change. Using a cross-over experimental design, 760 IDUs will be randomly assigned to one of four conditions: l. an expanded MI intervention that tailors the number of interventions to the individual's stage of change; 2. a case management model with an emphasis on securing services specific to the needs of the individual: 3. a combined MI and case-management approach; and, for comparison purposes, 4. the community-based intervention model we have used since 1987. Since psychological factors may account for the capacity to take advantage of interventions offered, and thus serve in a mediating role, we propose to include measures of psychological co-morbidity as potentially important outcome predictors.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Research Project (R01)
Project #
5R01DA009832-09
Application #
6604009
Study Section
Human Development Research Subcommittee (NIDA)
Program Officer
Hilton, Thomas
Project Start
1995-07-15
Project End
2005-05-31
Budget Start
2003-06-01
Budget End
2004-05-31
Support Year
9
Fiscal Year
2003
Total Cost
$785,308
Indirect Cost
Name
University of Colorado Denver
Department
Psychiatry
Type
Schools of Medicine
DUNS #
041096314
City
Aurora
State
CO
Country
United States
Zip Code
80045
Corsi, Karen F; Lehman, Wayne K; Booth, Robert E (2009) The effect of methadone maintenance on positive outcomes for opiate injection drug users. J Subst Abuse Treat 37:120-6
Booth, Robert E; Lehman, Wayne E; Brewster, John T et al. (2007) Gender differences in sex risk behaviors among Ukraine injection drug users. J Acquir Immune Defic Syndr 46:112-7
Corsi, Karen F; Kwiatkowski, Carol F; Booth, Robert E (2007) Treatment entry and predictors among opiate-using injection drug users. Am J Drug Alcohol Abuse 33:121-7
Booth, Robert E; Kwiatkowski, Carol F; Mikulich-Gilbertson, Susan K et al. (2006) Predictors of risky needle use following interventions with injection drug users in Ukraine. Drug Alcohol Depend 82 Suppl 1:S49-55
Booth, Robert E; Mikulich-Gilbertson, Susan K; Brewster, John T et al. (2004) Predictors of self-reported HIV infection among drug injectors in Ukraine. J Acquir Immune Defic Syndr 35:82-8
Booth, Robert E; Corsi, Karen F; Mikulich-Gilbertson, Susan K (2004) Factors associated with methadone maintenance treatment retention among street-recruited injection drug users. Drug Alcohol Depend 74:177-85
Booth, Robert E; Corsi, Karen F; Mikulich, Susan K (2003) Improving entry to methadone maintenance among out-of-treatment injection drug users. J Subst Abuse Treat 24:305-11
Kwiatkowski, Carol F; Fortuin Corsi, Karen; Booth, Robert E (2002) The association between knowledge of hepatitis C virus status and risk behaviors in injection drug users. Addiction 97:1289-94
John, D; Kwiatkowski, C F; Booth, R E (2001) Differences among out-of-treatment drug injectors who use stimulants only, opiates only or both: implications for treatment entry. Drug Alcohol Depend 64:165-72
Kwiatkowski, C F; Booth, R E (2001) Methadone maintenance as HIV risk reduction with street-recruited injecting drug users. J Acquir Immune Defic Syndr 26:483-9

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