Intravenous drug users (IVDUs) occupy a pivotal position in the AIDS epidemic because of their association with others who would not be at risk if it were not for their association with an IVDU. Second only to intravenous drug use, heterosexual contact with males at risk is the largest transmission category among women testing positive for the virus. Recently, the emergence of crack cocaine has prompted new fears, due both to its highly addictive nature and its association with sexual promiscuity. For the past two and a half years we have been a subcontractor in NIDA's Indigenous Leader Outreach efforts aimed at reducing HIV risks among intravenous drug users. We have interviewed over 500 IVDUs in this effort and have performed extensive analysis of these data. We are now proposing a controlled test of the enhanced features of that project. We are also proposing to expand the target population to include crack cocaine users and sexual partners. Specifically, a standard intervention approach, consisting of distribution of prevention packets and educational materials, will be compared to an Intensive Extended-network intervention, including the same components as the standard model plus the use of indigenous outreach staff who serve as public health advocates. Outreach workers engage high risk individuals in assessing risk, exploring alternative strategies, and reinforcing these efforts through repeated contacts over time. Both models will include HIV testing with pre and post-test counseling, structured pre and post-test interviews and ethnography. We hypothesize that the enhanced intervention will produce greater risk reduction, more knowledge gain, and an increased number of corollary benefits (e.g. employment, treatment admissions) than will the standard approach. An experimental design will be utilized to test these hypotheses: each of two targeted sites with high volume intravenous and crack use will be randomly assigned either the enhanced or standard intervention for a 24-month period; following a three-month """"""""washout"""""""" period, a crossover will occur and the second intervention implemented for the same length of time in the same neighborhoods. Only one model will be active in a site at any point; however, over the course of the study both targeted neighborhoods will be exposed to both interventions. The study will be evaluation using both formative and summative methodologies. Analyses will employ repeated measures multivariate statistical techniques appropriate for crossover designs.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Research Project--Cooperative Agreements (U01)
Project #
5U01DA006912-02
Application #
3550378
Study Section
Special Emphasis Panel (SRCD (04))
Project Start
1990-09-30
Project End
1995-08-31
Budget Start
1991-09-01
Budget End
1992-08-31
Support Year
2
Fiscal Year
1991
Total Cost
Indirect Cost
Name
University of Colorado Denver
Department
Type
Schools of Medicine
DUNS #
065391526
City
Aurora
State
CO
Country
United States
Zip Code
80045
Johnson, Mark E; Pratt, Deborah K; Neal, David B et al. (2010) Drug users' test-retest reliability of self-reported alcohol use on the risk behavior assessment. Subst Use Misuse 45:925-35
Edwards, Jordan W; Fisher, Dennis G; Johnson, Mark E et al. (2007) Test-retest reliability of self-reported drug treatment variables. J Subst Abuse Treat 33:7-11
Booth, R E; Kwiatkowski, C F; Chitwood, D D (2000) Sex related HIV risk behaviors: differential risks among injection drug users, crack smokers, and injection drug users who smoke crack. Drug Alcohol Depend 58:219-26
Kwiatkowski, C F; Stober, D R; Booth, R E et al. (1999) Predictors of increased condom use following HIV intervention with heterosexually active drug users. Drug Alcohol Depend 54:57-62
Booth, R E; Kwiatkowski, C F; Stephens, R C (1998) Effectiveness of HIV/AIDS interventions on drug use and needle risk behaviors for out-of-treatment injection drug users. J Psychoactive Drugs 30:269-78
Rhodes, F; Wood, M M; Booth, R E (1998) Efficacy and effectiveness issues in the NIDA Cooperative Agreement: interventions for out-of-treatment drug users. National Institute on Drug Abuse. J Psychoactive Drugs 30:261-8
Koester, S; Booth, R E; Zhang, Y (1996) The prevalence of additional injection-related HIV risk behaviors among injection drug users. J Acquir Immune Defic Syndr Hum Retrovirol 12:202-7
Johnson, M E; Fisher, D G; Davis, D C et al. (1996) Assessing reading level of drug users for HIV and AIDS prevention purposes. AIDS Educ Prev 8:323-34
Booth, R E; Crowley, T J; Zhang, Y (1996) Substance abuse treatment entry, retention and effectiveness: out-of-treatment opiate injection drug users. Drug Alcohol Depend 42:11-20
Booth, R E (1995) Gender differences in high-risk sex behaviours among heterosexual drug injectors and crack smokers. Am J Drug Alcohol Abuse 21:419-32

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