This application is a revision to R01DA032217-01. With the growing number of HIV seropositives in the US, there is a need for increasing secondary prevention and optimizing primary HIV medical care. As many seropositives are unaware of their serostatus there is also a need for increased VCT programs that reach high risk individuals. Our prior social network oriented interventions have demonstrated diffusion of risk reduction and the ability to recruit seropositive injection drug users (IDUs). Given the substantial rates of sexual HIV transmission and high levels of drug resistant HIV among IDUs, as well as the chronic nature of injection drug use, there is a need for effective behavioral intervention strategies that address risk behaviors among IDUs and their risk network members that can be sustained.. There is also an urgent need to develop programs to engage and retain vulnerable drug using people living with HIV/AIDS (PLHAs) in primary HIV medical care. Engagement in HIV primary care has been found to predict virologic and clinical outcomes. Low and inconsistent engagement in HIV primary care contributes to African Americans'and IDUs'higher HIV morbidity and mortality rates compared to other HIV racial or exposure groups. The main goal of the proposed study, which builds on our prior interventions is to train IDU PHLAs to be peer health educators will (1) recruit high risk network members for VCT, (2) promote network risk reduction, and (3) promote engagement in HIV care and treatment by encouraging their HIV seropositive network members to schedule and keep HIV primary care appointments, realistic patient-provider role expectations, and social norms of discussing HIV medical care. We propose recruiting and randomly assigning half of 300 IDUs PLHAs (termed indexes), predominantly African American, to an experimental peer health educator training and half to an attention control condition. Participants in both conditions will be encouraged to recruit high ris network members for VCT. We anticipate 270 networks will enroll. To enhance sustainability of intervention effects, experimental participants and their network members will be offered support sessions on HIV care. We expect that the peer health educator role will be perceived as meaningful to IDUs, who have minimal opportunities for prosocial roles, and that social rewards will help sustain peer health education and social diffusion of intervention effects. Moreover this approach can provide PLHA with training in goal setting, problem solving, and communication skills that can be applied to personal and professional situations.

Public Health Relevance

This study represents a low cost, sustainable intervention approach, with potential high impact by reaching and engaging drug users, PLHAs, and other community members in primary and secondary HIV prevention. The intervention will also promote VCT and optimization of HIV primary medical care. The proposed intervention is designed to diffuse behavior change to social networks members and provide meaning for social roles for peer health educators.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Research Project (R01)
Project #
1R01DA032217-01A1
Application #
8262276
Study Section
Behavioral and Social Consequences of HIV/AIDS Study Section (BSCH)
Program Officer
Jenkins, Richard A
Project Start
2011-09-15
Project End
2016-05-31
Budget Start
2011-09-15
Budget End
2012-05-31
Support Year
1
Fiscal Year
2011
Total Cost
$771,118
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
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Latkin, Carl A; Edwards, Catie; Davey-Rothwell, Melissa A et al. (2018) The relationship between drug use settings, roles in the drug economy, and witnessing a drug overdose in Baltimore, Maryland. Subst Abus :1-6
Smith, M Kumi; Graham, Matthew; Latkin, Carl A et al. (2018) Using Contact Patterns to Inform HIV Interventions in Persons Who Inject Drugs in Northern Vietnam. J Acquir Immune Defic Syndr 78:1-8
Latkin, Carl A; Tseng, Tuo-Yen; Davey-Rothwell, Melissa et al. (2017) The Relationship between Neighborhood Disorder, Social Networks, and Indoor Cigarette Smoking among Impoverished Inner-City Residents. J Urban Health 94:534-541
Flath, Natalie; Tobin, Karin; King, Kelly et al. (2017) Enduring Consequences From the War on Drugs: How Policing Practices Impact HIV Risk Among People Who Inject Drugs in Baltimore City. Subst Use Misuse 52:1003-1010
Latkin, Carl A; Edwards, Catie; Davey-Rothwell, Melissa A et al. (2017) The relationship between social desirability bias and self-reports of health, substance use, and social network factors among urban substance users in Baltimore, Maryland. Addict Behav 73:133-136
Rao, Amrita; Tobin, Karin; Davey-Rothwell, Melissa et al. (2017) Social Desirability Bias and Prevalence of Sexual HIV Risk Behaviors Among People Who Use Drugs in Baltimore, Maryland: Implications for Identifying Individuals Prone to Underreporting Sexual Risk Behaviors. AIDS Behav 21:2207-2214
Yang, Yi; Latkin, Carl; Luan, Rongsheng et al. (2016) Reality and feasibility for pharmacy-delivered services for people who inject drugs in Xichang, China: Comparisons between pharmacy staff and people who inject drugs. Int J Drug Policy 27:113-20
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

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