Dr. Spielberg's goal with this award is to gain the multidisciplinary tools required to become a successful independent investigator in HIV prevention and substance abuse health services research. Her current research involves a randomized evaluation of factors influencing HIV testing acceptance among injection drug users (IDU), including methods of sampling (oral vs. blood), methods of assay (rapid vs. standard), and methods of risk-reduction (written materials providing information and recommendations on HIV risk reduction vs. face- to-face client-centered counseling). This research demonstrates that needle exchange clients are more likely to accept and complete testing when offered the option of receiving written materials instead of face-to-face risk-reduction counseling. Now it is crucial to compare the impact of these two counseling strategies on HIV risk behaviors, in order to develop optimal risk reduction strategies for IDU. However, to accomplish this the applicant requires additional training in the design, implementation, and cost-effectiveness analysis of behavioral interventions to reduce HIV risk among substance users and their partners. This proposal will provide these skills through an integrated approach employing collaboration with a multidisciplinary team of established research mentors and targeted course work designed to build upon the candidate's background in family medicine and prior research studies, in order to expand her theoretical and methodological areas of expertise. As part of this training a series of three focused, supervised research studies are proposed, to include: 1) a randomized comparison of the impact of client-centered HIV counseling (Project Respect model) vs. written materials to decrease reported HIV risk behaviors in a cohort of IDU undergoing HIV testing. 2) A retrospective analysis of data available in Seattle from the HIV Network for Prevention Trials (HIVNET) national cohort of over 4000 high risk individuals, including 1124 IDU, to assess the association of observed rates of incident HIV infection with changes in reported risk behaviors. And 3) A cost-effectiveness analysis of HIV counseling and testing strategies using data from an ongoing randomized comparison of acceptance rates (to be completed 3/2000), data on risk behavior change with counseling interventions proposed in study number 1, and data linking reported behaviors with actual HIV incidence proposed in study number 2, to estimate the impact of these counseling strategies on HIV incidence among IDU. In addition, the cost-effectiveness of the two interventions on Quality Adjusted Life Years Saved (QALYS) will be determined, using published data linking HIV infection to QALYS, which will allow communities to compare the cost and benefits of these HIV prevention efforts to other prevention efforts using the same unit of measure. The applicant's goal with this funding is to gain critical new skills in the design, implementation, and analysis of behavioral interventions to reduce HIV risk among substance users and their partners, while providing new information to help guide the selection of effective HIV prevention interventions for these populations.

National Institute of Health (NIH)
National Institute on Drug Abuse (NIDA)
Clinical Investigator Award (CIA) (K08)
Project #
Application #
Study Section
Human Development Research Subcommittee (NIDA)
Program Officer
Lambert, Elizabeth
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
University of Washington
Family Medicine
Schools of Medicine
United States
Zip Code
Spielberg, Freya; Kurth, Ann E; Severynen, Anneleen et al. (2011) Computer-facilitated rapid HIV testing in emergency care settings: provider and patient usability and acceptability. AIDS Educ Prev 23:206-21
Spielberg, Freya; Kurth, Ann; Reidy, William et al. (2011) Iterative evaluation in a mobile counseling and testing program to reach people of color at risk for HIV--new strategies improve program acceptability, effectiveness, and evaluation capabilities. AIDS Educ Prev 23:110-6
Vazin, Tandis; Chen, Jia; Spivak, Charles E et al. (2008) Dopaminergic neurons derived from BG01V2, a variant of human embryonic stem cell line BG01. Restor Neurol Neurosci 26:447-58
Vazin, Tandis; Chen, Jia; Lee, Chun-Ting et al. (2008) Assessment of stromal-derived inducing activity in the generation of dopaminergic neurons from human embryonic stem cells. Stem Cells 26:1517-25
Zeng, Xianmin; Chen, Jia; Deng, Xiaolin et al. (2006) An in vitro model of human dopaminergic neurons derived from embryonic stem cells: MPP+ toxicity and GDNF neuroprotection. Neuropsychopharmacology 31:2708-15
Cai, Jingli; Chen, Jia; Liu, Ying et al. (2006) Assessing self-renewal and differentiation in human embryonic stem cell lines. Stem Cells 24:516-30
Spielberg, Freya; Branson, Bernard M; Goldbaum, Gary M et al. (2005) Choosing HIV Counseling and Testing Strategies for Outreach Settings: A Randomized Trial. J Acquir Immune Defic Syndr 38:348-55
Spielberg, Freya; Branson, Bernard M; Goldbaum, Gary M et al. (2003) Designing an HIV counseling and testing program for bathhouses: the Seattle experience with strategies to improve acceptability. J Homosex 44:203-20
Spielberg, Freya; Branson, Bernard M; Goldbaum, Gary M et al. (2003) Overcoming barriers to HIV testing: preferences for new strategies among clients of a needle exchange, a sexually transmitted disease clinic, and sex venues for men who have sex with men. J Acquir Immune Defic Syndr 32:318-27