AIDs continues to represent a critical issue for society. Despite significant developments on many fronts, the somber morbidity and mortality statistics remain. Intravenous drug abusers (IVDAs) comprise the second largest risk group and play a significant role in the prevalence of AIDS among adult females, heterosexuals, the pediatric age group, ethnic/racial minorities and New Yorkers. While drug abuse treatment has been advance as an HIV prevention strategy, many areas of difficulty exists in the delivery of drug treatment today. Concerned about the implications this holds for the nearly 2,100 patients under its care, the Addiction Research and Treatment Corporation (ARTC) proposes to establish a Treatment Research Unit (TRU) with a five year plan: 1. To increase enrollment in drug treatment of 300 persons dependent upon psychoactive substances that are associated with parenteral routes of administration or that are associated with disinhibiting behaviors that place these persons at risk of HIV infection; 2. To evaluate the efficacy of various pharmacologic and non- pharmacologic interventions that will reduce drug/sex behaviors associated with HIV transmission of HIV disease progression among persons enrolled in drug treatment; and 3. To identify factors (demographic, behavioral, and biomedical) associated with the success of various interventions to reduce HIV-associated transmission behaviors. Both survey/epidemiologic and ethnographic methods will be utilized to evaluate pharmacologic protocols, acupuncture, clinically guided self help and primary medical care study designs. The major theme of this Treatment Research Center (TRU) is the investigation of methods to improve methadone maintenance treatment. During the life of this TRU, flexibility will allow the examination of not only what interventions work and do not work, but also help explain why some approaches work in some circumstances and not in others.
