The Dayton-Columbus AIDS Outreach/Prevention Project will demonstrate and evaluate outreach methods for AIDS prevention aimed at IV drug abusers and their sex partners, modeling a regional, multi-city approach combining medical schools, drug treatment programs, health departments and other human service agencies. The region's low seropositivity rates and large numbers of IVDA's will be studied. Project goals include: examining the use of indigenous outreach workers; comparing two risk-behavior change methods; assessing how education and community organization effects prevention activities; estimating the epidemiology of HIV seropositivity; survey risk behaviors in IVDAs and producing a ethnography of IVDA's in an isolated, non-metropolitan area. A sample of 400 active abusers and 200 partners will be obtained in each city by using the street, hospital E.R.'s, and county jails as contact sites. These objects will provide data about risk behaviors and be tested for HIV antibodies. Seropositives, using standard health department protocols, will be referred for those AIDS counseling and support services currently provided. Seronegatives will be randomized to 2 levels of AIDS education/prevention. Level I (control) provides information about HIV/AIDS, its transmission, how to avoid information, and referral to drugs abuse treatment. Level II (exper) provides the same information and referral to drug abuse treatment as those in Level I. In addition, counseling sessions teach focused behavior- changes; and in introduction to drug treatment program services and encounters with recovering people are provided. Follow-ups assess behavioral changes at 6, 12, and 18 month intervals, and test for the presence of HIV antibodies. All seropositives will be counseled and referred to the appropriate health agency for counseling and health care services. Health Departments in Dayton and Columbus will perform all testing, AIDS counseling and education; hospitals and drug treatment programs will staff outreach activities, community education, and ethnographic data collection. Ethnographies and detailed outreach and education/prevention protocols will be developed. An examination of ethical issues in AIDS research/prevention will produce service and research protocols.
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