By the year 1990, it is estimated that there will be between 1,500 and 2,000 AIDS cases in Minnesota. In Minnesota, like most other states, excluding New York and New Jersey, the prevalence of HIV antibody among intravenous drug uses is below 5%. The goal of the proposed community-based intervention project is to limit HIV antibody prevalence from exceeding 10% in IV drug users, and limit the spread of AIDS in sexual partners of IV drug users and prostitutes. To achieve this goal, multiple, coordinated, and time-phased outreach, prevention, education, services and referrals, and behavioral change interventions aimed at getting IV drug users into treatment and/or reducing risk behaviors (using drugs, injecting drugs, sharing injection equipment, and not using condoms) among targeted groups will be implemented. The plan is to reach 2500 individuals in high risk groups in multiple settings in two counties (Hennepin and Ramsey). Seventy percent of the AIDS cases in Minnesota are in Hennepin County. Indigenous workers and community health specialists will make contact with the target populations in high-risk neighborhoods (e.g., streets), formal institutions (e.g., correctional facilities) and community agencies (e.g., counselling and testing sites, maternal-child health clinics), recruit individuals to voluntarily complete the NIDA questionnaire, and participate in a range of intervention activities. Activities are also planned to involve community establishments (e.g., pharmacies, bars, convenience stores) to create environments that are supportive of promoting and maintaining positive behavior change. A cohort sequential quasi-experimental design is proposed to address the questions of which interventions in which setting are most effective with which risk groups in increasing awareness and knowledge, reducing risk behaviors and ultimately limiting the spread of HIV infection among IV drug users, sexual partners of IV drug users and prostitutes. Process and outcome evaluations are planned. Descriptive, bivariate and multivariate statistical strategies will be used to document change and assess the efficacy and effectiveness of the interventions.
