The overall goal of this study is to develop a monitoring system and to evaluate the effectiveness of a community-based intervention designed to reduce the incidence and spread of HIV/AIDS and needle use-among injecting drug abusers, their sexual partners and individuals at demonstrated risk for injecting drug use not in treatment. The study will be conducted in a low-prevalence area by the University of Kentucky, in collaboration with the Lexington Community Action Council and the Louisville Volunteers of America. The specific study aims are to: (1) Establish a monitoring system (N = 2928); (2) Complete a formative pilot study to refine the interventions for rural and Appalachians during the initial six months; (3) Recruit 1066 injecting drug users and sex partners into two levels of the interventions; (4) Randomly assign 533 subjects recruited in the study monitoring phase to each of two levels of intervention; (5) Conduct a process-and-outcome evaluation to assess the efficacy of the two levels of the intervention using NIDA instrumentation; (6) Target rural and Appalachian drug abusers who will make up at least 25% (N = 732) of the study monitoring system subjects and 25% (N = 266) of study intervention subjects who, based on preliminary/pilot studies, are at high risk for HIV and examine risks and possible differences, including migration; and (7) Cooperate with NIDA for standard data collection, evaluation, analyses and publications.
