High rates of AIDS, ARC and HIV antibody seroprevalence exist among intravenous (IV) drug users; seropositivity findings have ranged as high as 60%. Prisons contain large numbers of inmates with histories of IV substance abuse (estimated at 25% of all inmates). Upon release back into the community, they are at risk of reverting to IV drug use with the associated dangers of contracting and/or transmitting HIV. This study proposes to develop and evaluate an AIDS prevention training program for parolees. The sample will be 300 males with IV drug abuse histories who have been released from the state prisons to parole. Of these, 150 will be parolees who completed prison-based drug treatment programs and 150 who did not attend such programs. Parolees in each group will then be randomly assigned to either of two conditions: (1) Prevention Treatment (HIV antibody testing and AIDS prevention training, N=150 (2) Control (No study intervention, N=150). Knowledge of HIV antibody status is intended to increase parolees' motivation for risk reduction. AIDS prevention training will be based on self-help principles that have been successfully utilized in prison-based therapeutic community treatment of substance abuse and will include a """"""""life skills"""""""" prevention curriculum; parolees will attend for two months. The purpose is to assist parolees with past IV drug abuse to avoid behaviors that either would expose them to HIV if they test HIV antibody seronegative, or reduce the probability of transmitting the virus and/or developing AIDS if they test seropositive. All subjects will be followed-up at 1 year. The primary outcome variables will be: increases in knowledge and positive attitudes about AIDS prevention; avoidance of IV drug use and particularly non-sterile drug use; use of safe sex practices. The study analyses will determine the individual and joint effects of prison-based drug treatment and parole-based AIDS prevention treatment on AIDS risk-reduction. A unique feature of the study will be determination of HIV antibody seroprevalence in a representative sample of just-released prison immates, the first such data for New York State.
| Wexler, H K; Magura, S; Beardsley, M M et al. (1994) ARRIVE: an AIDS education/relapse prevention model for high-risk parolees. Int J Addict 29:361-86 |
