The purpose of the proposed project is to (1) evaluate the effectiveness of an HIV prevention model among intravenous drug abusers not in drug treatment and their sexual partners and (2) to monitor changes in HIV related and drug abusing behaviors among the study population over time. The planned HIV prevention model is based upon the Health Belief Model developed by Janz and Becker. The theoretical concepts of the model will be applied using an enhanced HIV pre-test counseling format. Respondents for the study will be recruited from target neighborhoods using aggressive community-based outreach techniques. Pre-test data will be collected using the AIDS Initial Assessment Interview. Respondents will be randomly assigned to receive a standard (quasi-control) or enhanced (quasi-experimental) HIV pre-test data will be collected using the AIDS Initial Assessment Interview. Respondents will be randomly assigned to counseling session. The standard HIV pre-test counseling session will be the required Centers for Disease Control format. The enhanced intervention will present the same basic information, but will differ in that it will utilize an interactive, one to one session to teach cognitive, behavioral, and social skills believed to have an impact on the needle cleaning, drug abusing, and sexual behaviors of the respondents. Blood will be collected for HIV testing after the counseling sessions. Evaluation of the intervention and monitoring will be accomplished using quantitative and ethnographic methods. AIDS Follow up Assessment Surveys will be administered to 75% of initial respondents at three and six months. Ethnography will utilize overt participant observation and in depth interviews. Both methodologies will be used to assess change in community behaviors, perceptions and relationships over time. The proposed study will contribute to our expanding knowledge of the relationship between IV drug abuse and HIV infection, drug abusing habits and behaviors of IV drug abusers not in treatment, and the relationship between IV drug abusers and their sexual partners. In a more practical vein, the study will add to our limited knowledge of how to effective design and implement health prevention strategies among IV drug abusers not in drug treatment programs.
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