This proposed planning initiative is designed to: 1) increase our understanding and knowledge of HIV risks factors which are specific to middle-aged and older African American male and female users of crack cocaine, and; 2) demonstrate the effectiveness of an age- specific outreach intervention designed to gain access to target group members, increase AIDS knowledge and health risk (e.g. HIV; STD) awareness, assist clients in assessing individual health risk, and promote drug free living. Utilizing a pre-post test intervention design, we will recruit and collect baseline data on three groups of persons: (1) middle aged and older sexually active men (aged >50) for whom crack cocaine is the primary drug of choice (n=40); (2) middle aged and older sexually active women (aged >50) for whom crack cocaine is the primary drug of choice (n=40), and; (3) sexual partners; individuals who have engaged in a sexual act with members in groups 1 or 2 (n=80). Serologic testing for HIV and syphilis, and urine or vaginal swab for testing gonorrhea and chlamydia will be conducted on all study participants. We will conduct one post intervention assessment (including biologic test) in month 9 with Groups 1 and 2 only. These data will be used to describe and compare demographic, serologic, and HIV risk characteristics of older crack cocaine users and their sexual partners; measure and evaluate intervention impact and exposure. In parallel with these quantitative assessments, the qualitative, ethnographic component will consistent of ongoing direct observation augmented by 2 ethnographic interviews per week during the first year of the study and subsequent diminution to 1 interview per week until the conclusion of the study or until redundancy is reached. The ethnographic interviews will be held with selected study participants, their contacts, and other key informants (e.g. landlords, shopkeepers, persons involved in drugs in these neighborhoods, etc.).
