The major objective of the proposed investigation is to evaluate: 1) the mediating variables associated with changing HIV risk behavior; and 2) the impact of psychoeducational (PE) HIV Risk Reduction training added to a drug abuse treatment program, compared to that of a conventional didactic procedure. To accomplish this goal, selected drug dependent patients admitted to the Miami Veterans Affairs Medical Center Drug Dependence Treatment Program will be randomly assigned to (a) an Information (INFO) condition in which subjects receive brochures describing HIV transmission and risk reduction, or (b) a Psychoeducational (PE) condition modeled after Heitzman, Sorensen, et al. (1988). Subjects in the PE condition will receive brochures and will also participate in group sessions in which HIV risk reduction instruction is provided, incorporating optimal behavioral change strategies. Self reports of risk behavior and behavioral demonstrations of lower risk behaviors such as condom use and needle cleaning will be measured prior to intervention and at 3, 6, and 12 months following intervention. A second objective is to administer a stronger version of PE than previous studies which have produced HIV risk behavior reductions among drug addicts. A third objective is to measure the influence of extratherapeutic factors, including the quality and quantity of drug abuse treatment received and life context variables (e.g., social support, resources, and stressors). Additional objectives are to: (a) monitor patients' involvement in various components of the HIV prevention intervention and to relate level of involvement to proximal and ultimate outcome variables; (b) control for the effect of information on intervention outcome; (c) evaluate immediate and enduring effects of intervention by assessing outcome over one year; and (d) include objective measures of drug treatment outcome (e.g., drug testing, compliance with aftercare) and staff verification of patients' self-report data.
