Current HIV prevention interventions have been predominantly influenced by several cognitive theories. While individual-level theory has been successful in guiding small and intensive group interventions, their effectiveness may be limited in contexts where targeted behaviors are constrained by complex social and environmental factors, especially in developing countries or among communities engaging in illicit behaviors. Community-norm change models that focus on influencing social or peer norms may be more effective in reaching those at highest risk and least likely to volunteer for individually-based interventions. However, there are few studies that evaluated the efficacy of such interventions in developing countries. This study is a randomized controlled trial of a peer educator, network-oriented intervention for injecting drug users (IDUs) and their sexual partners in northern Vietnam. IDUs account for over 88 percent of all reported HIV infections, making them and their drug-using and sexual partners a critical target for HIV prevention efforts. IDU is increasing rapidly in Vietnam, accompanied by an increase in commercial sex work. The potential exists for an explosive shift of transmission dynamics from the core group of IDUs to the general population, as was seen in Thailand. This shift could be mediated by sexual and drug network members as a bridge population to susceptibles in other settings. Current low HIV and STD rates in the general population highlight the need to implement appropriate and effective behavioral interventions in the complex social and ethnographic environment surrounding IDUs and their peer networks. To accomplish this trial, we will: 1) conduct ethnographic research to culturally adapt our peer educator, network oriented intervention and to determine the acceptability of this intervention; 2) enroll and interview a cohort of 400 indexes and three of their sexual/injecting network members (total n = 1600) to determine baseline sexual, drug and biologic (chlamydia, gonorrhea, HBV and HCV) characteristics; 3) randomize index participants to a 6-session network-oriented peer-led intervention or an attention control condition. After randomization, participants will be followed for a minimum of 15 and maximum of 24 months at 6-month intervals. Follow-up visits will consist of a behavioral survey and donation of biological specimens; and 4) compare sexual and drug behavioral risks and HIV VCT uptake among the indexes who receive the intervention and their network members to index IDUs who received the attention controlled sessions and their network members.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
5R01MH064895-03
Application #
6790481
Study Section
Special Emphasis Panel (ZMH1-NRB-W (01))
Program Officer
Pequegnat, Willo
Project Start
2001-09-30
Project End
2006-08-31
Budget Start
2004-09-01
Budget End
2005-08-31
Support Year
3
Fiscal Year
2004
Total Cost
$483,757
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
Zhang, Long; Celentano, David D; Le Minh, Nguyen et al. (2015) Prevalence and correlates of HCV monoinfection and HIV and HCV coinfection among persons who inject drugs in Vietnam. Eur J Gastroenterol Hepatol 27:550-6
Go, Vivian F; Minh, Nguyen Le; Frangakis, Constantine et al. (2013) Decreased injecting is associated with increased alcohol consumption among injecting drug users in northern Vietnam. Int J Drug Policy 24:304-11
Go, Vivian F; Frangakis, Constantine; Le Minh, Nguyen et al. (2013) Effects of an HIV peer prevention intervention on sexual and injecting risk behaviors among injecting drug users and their risk partners in Thai Nguyen, Vietnam: a randomized controlled trial. Soc Sci Med 96:154-64
Quan, Vu Minh; Minh, Nguyen Le; Ha, Tran Viet et al. (2011) Mortality and HIV transmission among male Vietnamese injection drug users. Addiction 106:583-9
Go, Vivian F; Frangakis, Constantine; Van Nam, Le et al. (2011) Characteristics of high-risk HIV-positive IDUs in Vietnam: implications for future interventions. Subst Use Misuse 46:381-9
Schumacher, Christina M; Go, Vivian F; Nam, Le Van et al. (2009) Social injecting and other correlates of high-risk sexual activity among injecting drug users in northern Vietnam. Int J Drug Policy 20:352-6
Quan, Vu Minh; Go, Vivian F; Nam, Le Van et al. (2009) Risks for HIV, HBV, and HCV infections among male injection drug users in northern Vietnam: a case-control study. AIDS Care 21:7-16
Bergenstrom, Anne; Quan, Vu Minh; Van Nam, Le et al. (2008) A cross-sectional study on prevalence of non-fatal drug overdose and associated risk characteristics among out-of-treatment injecting drug users in North Vietnam. Subst Use Misuse 43:73-84
Go, Vivian F; Solomon, Suniti; Srikrishnan, Aylur K et al. (2007) HIV rates and risk behaviors are low in the general population of men in Southern India but high in alcohol venues: results from 2 probability surveys. J Acquir Immune Defic Syndr 46:491-7
Bergenstrom, A; Go, V; Nam, L V et al. (2007) Return to post-test counselling by out-of-treatment injecting drug users participating in a cross-sectional survey in north Vietnam. AIDS Care 19:935-9

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