This study is a randomized controlled trial of a multilevel social-behavioral intervention for HIV-positive injecting drug users (IDUs) in Vietnam. Our ongoing NIMH-funded study at the same site found high HIV prevalence (42%) among IDUs. Among HIV-positive IDUs, 64% percent shared injecting equipment and 65% of sexually active IDUs engaged in unprotected sex in the past year. The intervention draws on social action, social identity and diffusion of innovation theories. At the structural level, the intervention consists of 2 community-based stigma reduction programs;at the individual level it consists of 2 posttest counseling sessions and 3 skill-building support groups for HIV positive IDUs. The study approach is innovative for 4 reasons: 1) It addresses structural and individual barriers to risk reduction;2) It addresses stigma, which is a primary obstacle to risk reduction for HIV-positive individuals and for which few community level efforts have been undertaken;3) It promotes sustainability by utilizing longstanding and highly effective grassroots organizations in Vietnam;and 4) It enhances various dimensions of social support in the community (""""""""meals on motorcycles"""""""" provides instrumental and emotional support), among non-injecting network members (""""""""person important to me"""""""" sessions help non-injecting network members support IDUs in their risk reduction goals), and among peers (support group sessions offer emotional and instrumental support). To accomplish this trial, we will: 1) conduct ethnographic research to culturally adapt our intervention;2) select 8 villages and enroll and interview a cohort of 404 HIV-positive IDUs (index) and one of their HIV-negative injecting partners to determine baseline prevalence of sexual and drug risk factors;3) randomize villages to a stigma- reduction or control arm and within each of the 8 villages, further randomize index participants to enhanced posttest counseling and support sessions or an attention-controlled arm;this final randomization will result in 4 study arms and index participants will be assessed at 3, 6, 12, 18 and 24 months for behavioral outcomes while injecting partners will be followed at 24 months to determine HIV incidence;and 4) compare HIV behavioral risks among index participants in the arm that receives both structural and individual level activities to the control arm. We hypothesize that the 2-level intervention will reduce injecting and sexual risk behaviors of HIV-positive IDUs and provide a potential model for reducing HIV-transmission in Vietnam.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Research Project (R01)
Project #
5R01DA022962-05
Application #
8073492
Study Section
Behavioral and Social Consequences of HIV/AIDS Study Section (BSCH)
Program Officer
Jenkins, Richard A
Project Start
2007-07-20
Project End
2013-06-30
Budget Start
2011-07-01
Budget End
2013-06-30
Support Year
5
Fiscal Year
2011
Total Cost
$617,341
Indirect Cost
Name
Johns Hopkins University
Department
Public Health & Prev Medicine
Type
Schools of Public Health
DUNS #
001910777
City
Baltimore
State
MD
Country
United States
Zip Code
21218
Levintow, Sara N; Pence, Brian W; Ha, Tran Viet et al. (2018) Depressive Symptoms at HIV Testing and Two-Year All-Cause Mortality Among Men Who Inject Drugs in Vietnam. AIDS Behav :
Go, Vivian F; Frangakis, Constantine; Le Minh, Nguyen et al. (2017) Increased Survival Among HIV-Infected PWID Receiving a Multi-Level HIV Risk and Stigma Reduction Intervention: Results From a Randomized Controlled Trial. J Acquir Immune Defic Syndr 74:166-174
Blackburn, N A; Lancaster, K E; Ha, T V et al. (2017) Characteristics of persons who inject drugs and who witness opioid overdoses in Vietnam: a cross-sectional analysis to inform future overdose prevention programs. Harm Reduct J 14:62
Go, Vivian F; Latkin, Carl; Le Minh, Nguyen et al. (2016) Variations in the Role of Social Support on Disclosure Among Newly Diagnosed HIV-Infected People Who Inject Drugs in Vietnam. AIDS Behav 20:155-64
Latkin, Carl A; Mai, Nguyen Vu Tuyet; Ha, Tran Viet et al. (2016) Social Desirability Response Bias and Other Factors That May Influence Self-Reports of Substance Use and HIV Risk Behaviors: A Qualitative Study of Drug Users in Vietnam. AIDS Educ Prev 28:417-425
Latkin, Carl A; Smith, M Kumi; Ha, Tran Viet et al. (2016) Roles and Functions of Social Networks Among Men Who Use Drugs in ART Initiation in Vietnam. AIDS Behav 20:2782-2789
Go, Vivian F; Frangakis, Constantine; Minh, Nguyen Le et al. (2015) Efficacy of a Multi-level Intervention to Reduce Injecting and Sexual Risk Behaviors among HIV-Infected People Who Inject Drugs in Vietnam: A Four-Arm Randomized Controlled Trial. PLoS One 10:e0125909
Lim, Travis W; Davis, Wendy W; Quan, Vu Minh et al. (2014) ASSOCIATION BETWEEN HIV KNOWLEDGE AND RISK BEHAVIOR IN PERSONS WHO INJECT DRUGS IN THAI NGUYEN, VIETNAM. Southeast Asian J Trop Med Public Health 45:1425-36
Lim, Travis W; Frangakis, Constantine; Latkin, Carl et al. (2014) Community-level income inequality and HIV prevalence among persons who inject drugs in Thai Nguyen, Vietnam. PLoS One 9:e90723
Lim, Travis; Zelaya, Carla; Latkin, Carl et al. (2013) Individual-level socioeconomic status and community-level inequality as determinants of stigma towards persons living with HIV who inject drugs in Thai Nguyen, Vietnam. J Int AIDS Soc 16:18637

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