This resubmission of an R03 application is based on the summary statement of an ROI(DA08156-OIAI) review. This proposed study seeks to pilot methods of recruiting, training, monitoring, and evaluating natural leaders in an AIDS preventive intervention trial. The distal outcome is reducing the spread of HIV in IDUs. The study builds on our recent finding of self- reported HIV risk reduction in an experimental trial targeted to drug sharing social networks of injection drug users (IDUs). Moreover, in a preliminary study, we found that mu participants report a strong interest in leaning strategies for communication with other IDUs discussing methods of HIV risk reduction. Guided by a social diffusion model, the study will utilize natural leaders as change agents in the injecting drug community in Baltimore. Natural leaders will be trained to conduct the intervention with their drug sharing network in their community setting. The study design will be quasi- experimental. The impact of the training on natural leaders' network members will be compared with a control group of network members and with controls and experiment subjects from our present SAFE, and ALIVE studies. This design allows for the comparison of the effect of natural leaders training their drug sharing social network in the community with both a control group of IDUs who do not receive the intervention and paraprofessionals training networks in a clinic. The targeted behaviors are unhygienic injection practices and unprotected sex. The target population is disadvantaged injecting drug users in an urban setting. Measures of risk reduction will be analyzed in both the leaders and their drug sharing social networks. Leaders in the injecting drug user community will be identified by our social network inventory. Two members of each drug sharing network will be randomly chosen for post-intervention assessment. Social psychological theories of leadership, social identity, and psychological empowerment will guide the data interpretation.
