this four-year longitudinal prospective study will utilize findings on drug-user social networks and drug use sites to test a peer-led intervention with active drug users and their networks, conducted in the places they gather to use drugs. The project is based on a study of high-risk drug use settings for HIV prevention (P01 MH/DA5 6826, Project #3).
Aims of the new study, entitled """"""""HIV Prevention in High-Risk Drug Use Sites: Project RAP (Risk Avoidance Partnership)"""""""" are to: 1) develop and implement in high-risk drug-use sites an intervention program using trained Peer Health Advocates (PHAs) who will reach site users and their risk networks with HIV prevention messages, materials, and model practices; 2) evaluate the efficacy of this site-based peer intervention program for reducing HIV risk and increasing protective behaviors among drug users and their risk network members; 3) document the diffusion of intervention messages and materials by PHAs into sites and through the drug-using networks associated with them; 4) describe the characteristics and network relationships of effective PHAs who successfully bring about long-term adoption of HIV prevention practices among their network contacts; and 5) initiate and document the development process of and activities associated with a drug-user-led Community Advocacy Group, as a vehicle for their own organization and mobilization to advocate for group-identified health concerns and other issues affecting drug users at risk. We will recruit and train 120 active drug users to conduct a specifically designed prevention intervention with their drug-using network members and sex partners. PHA training will include a 5-session curriculum followed by 5 sessions in which the PHA disseminates the intervention in the field in partnership with project staff. PHAs will refer into the project 360 network members (Contact Referrals-CRs) to whom they will provide intervention, and whom we will assess for number and type of intervention contacts, impact, and long-term effects. We also will conduct a """"""""community-wide survey"""""""" with 750 drug users in year 4 to assess the diffusion of prevention messages/materials through Hartford drug-using networks. This study uses a panel design with PHAs and CRs to measure changes in risk behaviors and adoption of prevention practices over time (baseline, 6-month follow-up, year-4 survey). The community-wide survey additionally allows analysis of intervention effects in the broader networks of drug users. Data collection methods include structured surveys and process tracking, as well as semi-structured interviews and ethnographic observation to document project activities and effects for process and outcome evaluation analyses.

National Institute of Health (NIH)
National Institute on Drug Abuse (NIDA)
Research Project (R01)
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Special Emphasis Panel (ZRG1-AARR-7 (01))
Program Officer
Kaftarian, Jackie Shakeh
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Institute for Community Research
United States
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Weeks, Margaret R; Kostick, Kristin; Li, Jianghong et al. (2015) Translation of the Risk Avoidance Partnership (RAP) for Implementation in Outpatient Drug Treatment Clinics. J Psychoactive Drugs 47:239-47
Li, Jianghong; Weeks, Margaret R; Borgatti, Stephen P et al. (2012) A social network approach to demonstrate the diffusion and change process of intervention from peer health advocates to the drug using community. Subst Use Misuse 47:474-90
Dickson-Gomez, Julia; Weeks, Margaret R; Convey, Mark et al. (2011) SOCIAL PSYCHOLOGICAL DYNAMICS OF ENHANCED HIV RISK REDUCTION AMONG PEER INTERVENTIONISTS. J Community Psychol 39:369-389
Convey, Mark R; Dickson-Gomez, Julia; Weeks, Margaret R et al. (2010) Altruism and peer-led HIV prevention targeting heroin and cocaine users. Qual Health Res 20:1546-57
Weeks, Margaret R; Convey, Mark; Dickson-Gomez, Julia et al. (2009) Changing drug users' risk environments: peer health advocates as multi-level community change agents. Am J Community Psychol 43:330-44
Weeks, Margaret R; Li, Jianghong; Dickson-Gomez, Julia et al. (2009) Outcomes of a peer HIV prevention program with injection drug and crack users: the Risk Avoidance Partnership. Subst Use Misuse 44:253-81
Dickson-Gomez, Julia; Hilario, Helena; Convey, Mark et al. (2009) The relationship between housing status and HIV risk among active drug users: a qualitative analysis. Subst Use Misuse 44:139-62
Dickson-Gomez, Julia; Weeks, Margaret; Martinez, Maria et al. (2006) Times and places: Process evaluation of a peer-led HIV prevention intervention. Subst Use Misuse 41:669-90
Weeks, Margaret R; Dickson-Gomez, Julia; Mosack, Katie E et al. (2006) The Risk Avoidance Partnership: Training Active Drug Users as Peer Health Advocates. J Drug Issues 36:541-570