|
Methadone Treatment - IDU |
| Many articles support
the effectiveness of methadone treatment as an HIV prevention
intervention for heroin users. The studies show that methadone
treatment reduces needle use, sharing and number of sex
partners. Rather than summarizing each article, this document
provides several citations to help users begin to access the
literature on this topic. Gibson DR, Flynn NM, and McCarthy JJ
(1999). Effectiveness of methadone treatment in reducing HIV
risk behavior and HIV seroconversion among injecting drug users.
AIDS 13: 1807-1818.
Hubbard RL, Marsden ME, Rachel JV, et al. (1989). Drug
Abuse Treatment: A National Study of Effectiveness (Chapel
Hill, NC: University of North Carolina Press, 1989), cited in
The Effectiveness of AIDS Prevention Efforts (Washington DC:
Office of Technology Assessment).
Langendam MW, van Brussel GHA, Coutinho RA, et al. (1999).
Methadone maintenance treatment modalities in relation to
incidence of HIV: results of the Amsterdam cohort study. AIDS
13: 1711-1716.
Rhoades HM, Creson D, Elk R, et al. (1998). Retention, HIV
risk, and illicit drug use during treatment: methadone dose and
visit frequency. American Journal of Public Health 88:
34-39. |
|
Syringe Exchange - IDU
Back to Top |
| Many articles support
the effectiveness of syringe exchange as an HIV prevention
intervention for injection drug users. The studies show that
syringe exchange programs reduce sharing and increase referrals
to drug treatment programs, without increasing injection drug
use. Rather than summarizing each article, this document
provides several citations to help users begin to access the
literature on this topic. Ashery, RS, Davis H, Davis WH, et
al. (1993). Entry into treatment of IDUs based on the
association of outreach workers with treatment programs.
Handbook on Risk of AIDS, Brown BS and
Beschner GM (eds.) (Westport, CT: Greenwood Press), cited in
The Effectiveness of AIDS Prevention Efforts (Washington DC:
Office of Technology Assessment).
Bluthenthal RN, Kral AH, Gee L, et al. (2000). The effect of
syringe exchange use on high-risk injection drug users: a cohort
study. AIDS 14: 605-611.
Hagan H, Des Jarlais DC, Friedman SR, et al. (1995). Reduced
risk of Hepatitis B and Hepatitis C among injecting drug users
participating in the Tacoma Syringe Exchange Program.
American Journal of Public Health 85: 1531-1537.
O’Brien M, Murray JR, Rahemian A, et al. (1994). Three topics
from the Chicago Needle Exchange Cohort Study: seroconversion;
the behavior of HIV-positive NX users; and the need for
additional prevention around non-needle injection risks.
Annual North American Syringe Exchange Conference, Santa
Cruz, CA, cited in The Effectiveness of AIDS Prevention
Efforts (Washington DC: Office of Technology Assessment).
O’Keefe E, Kaplan E, and Khoshnood K (1991). Preliminary
Report: City of New Haven Needle Exchange Program (New
Haven, CT: New Haven Health Department), cited in The
Effectiveness of AIDS Prevention Efforts (Washington DC:
Office of Technology Assessment).
Oliver K, Maynard H, Friedman SR, et al. (1994). Behavioral
and community impact of the Portland Syringe Exchange Program.
Proceedings of the Workshop on Needle Exchange and Bleach
Distribution Programs (Washington, DC: National Academy
Press), cited in The Effectiveness of AIDS Prevention Efforts
(Washington DC: Office of Technology Assessment). |
|
Individual-Level - IDU
Back to Top |
|
Sterk, C. E. (2002) The health intervention project: HIV risk
reduction among African America women drug users. Public
Health Reports. 2002 Volume 117, Supplemental 1, S88-S95. |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
|
African American women who use crack |
This Health Intervention Project (HIP) was conducted in Georgia
for African American crack users. The HIP consisted of two
interventions based on the Stages of Change Model. The four
session motivation intervention, including HIV pre and posttest
counseling. During the sessions, the women developed an action
plan, reviewed successes and failures, revised personal goals,
recognized triggers for relapse and developed ways to avoid or
respond to those cues. The four session negotiation intervention
focused on technical and communication skills. The women
developed an action plan and reviewed the plan during each
session. |
No
specific information about this intervention was provided.
However, lessons learned from this intervention determined
successful interventions must be holistic. Effective prevention
intervention programs must be framed within appropriate racial,
ethnic, and cultural context. |
| Stephens RC, Feucht
TE, et al. (1993) Effects of an Intervention Program on
AIDS-Related Drug and Needle Behavior Among Intravenous Drug
Users. American Journal of Public Health 81(5): 568-571. |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
POC
(African-American Male) |
322 (mostly street addicts not in
tx) participated in 1:1 counseling delivered by a professionally
trained health educator and lasted 45-60 minutes. Session
provided basic information on HIV transmission using a segment
of a film; discussed sexual risk reduction and condom use;
covered ways to reduce risk due to injection drug use and ended
with information on HIV testing. |
Pre-post results compared baseline
to 3-month follow-up interview. Percent reporting injecting
decreased from 92 to 71, sharing decreased from 67 to 24. Didn’t
ask questions about sexual risks. |
|
Prevention Case Management - IDU
Back to Top |
| The CDC has endorsed
Prevention Case Management (PCM) as an effective intervention to
reach HIV positive and/or very high-risk HIV negative persons.
PCM is a client-centered HIV prevention activity with the
fundamental goal of promoting the adoption and maintenance of
HIV risk reduction behaviors by clients with multiple, complex
problems and risk reduction needs. PCM provides
client-centered, multiple-session HIV risk reduction counseling
while using the service brokerage of traditional case management
to address competing needs that may make HIV prevention a lower
priority. This HIV prevention activity addresses the
relationship between HIV risk and other issues such as substance
use, mental health, adherence issues, social and cultural
factors, and physical health problems. While PCM has yet
to be rigorously evaluated, intensive case management
interventions for clients with multiple, complex problems have
been shown to be effective in other health fields.
CDC HIV Prevention Case Management – Guidance September
1997
CDC HIV Prevention Case Management – Literature Review and Current
Practice September 1997
CDC Abbreviations and Acronyms |
|
Group-Level - IDU
Back to Top |
| Cottler LB, Compton WM
et al. (1998) Peer-Delivered Intervention Reduces HIV Risk
Behaviors among Out-of-Treatment Drug Abusers. Public Health
Report 113(1): 31-41 |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| POC/ African-Am |
St. Louis Program (Each OneTeach
One). N=725, 61% male, 93% African-American. A peer role model
for out-of-tx crack cocaine users and IDU. Role Models conducted
outreach to reach persons on the street spending 5 to 15 minutes
contact with users, then random assignment to standard (SI) or
enhanced intervention (EI). All participants in two sessions of
drug and HIV info and C&T, then EI participants randomly
selected to attend four 2-hour peer-led intervention groups on
drug awareness, stress management, AIDS, risk reduction for
sexual behavior. |
3-month follow-up. Over 80% of the
sample (both groups) maintained their crack cocaine use at
low-level or reduced their use. Enhanced group more likely to
reduce risk. Condom use in both groups decreased. Men in EI more
likely to reduce crack use than SI men. No difference between
women in two groups. |
| Deren S, Tortu S. et
al. (1993) An AIDS Risk Reduction Project with Inner-city Women,
Women and AIDS: Psychological Perspectives. London: Sage. |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
POC/ Women
(African- Am/Latino) |
Women were randomly assigned to two
groups.
Group 1: a single group session providing AIDS education and
testing/risk reduction referral information.
Group 2: three group session, covering the above plus condom
use/needle-cleaning and negotiation skills.
|
Women in both interventions showed
significant decrease in average monthly number of unprotected
sex acts (37 to 19) and number of partners (31 to 15) in the
last 6 months. Increased percent condoms use with main partner
(18% to 43%) and with multiple partners (43% to 64%) at 6-month
follow-up. |
| Des Jarlais, C.C.,
Casriel, C., et al. (1992) AIDS and the Transition to Illicit
Drug Injection – Results of a Randomized Trial Prevention
Program. British Journal of Addiction 87(3): 493-498. |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| |
Study to see if teaching safer
injecting practices would cause injecting to increase among drug
sniffers. 104 NYC HIV negative heroin users who were using intranasaly
(sniffing) as their primary route of heroin use and who had
injected no more than 60 times in the previous two years.
Trained peer-mediator conducted four 60-90 minute group sessions
over a two-week period, which included AIDS 101, safer
injection, sexual behavior, and drug abuse treatment programs.
Controls filled out surveys that were in-depth interviews. |
Significant lower level of
injection at follow-up (average follow-up period = 9 months).
Did not prevent all drug injection. 15% assigned to the
intervention injected during the follow-up period, compared with
33% of those assigned to the control group. There however was
no evidence that the intervention was effect at improving safer
sex. |
| El-Bassel N, Schilling
RF (1992) 15- Month Follow-up of Women Methadone Patients Taught
Skills to reduce Heterosexual HIV Transmission. Public Health
Reports 107(5): 500-4. |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
IDU/ POC
(African-Am/ Hispanic) |
15-month follow-up of study
summarized above (Schilling RF, EL-Bassel et al. (1991) Building
Skills of Recovering Women Drug Users to Reduce Heterosexual
AIDS Transmission. Public Health Reports 106(3):
297-304). |
Compared to the information-only
group, women in the skills-building group showed an increase in
frequency of condom use at 15-month follow-up. The groups did
not differ significantly in number of sex partners. |
| Malow RE, West JA et
al. (1994) Outcome of Psychoeducation of HIV risk reduction.
AIDS Education and Prevention 6(2): 113-125. |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| POC/ Drug use (African American
cocaine users) |
152 African American males at
in-patient tx program participated in group-level sessions.
Non-peer led, held for 2 hours over 3 consecutive days, 6-8
people. Sessions included HIV knowledge/ risk, demonstrated
cleaning works; condom use, condom negotiating, and
skills-building exercises; review and discussion of HIV testing
procedures. |
47.5% of intervention group
participants reported having more than one partner at
three-month follow-up compared to 76% at the baseline, in the
comparison group. The change from 76% at baseline to 59%
at the follow was considered to be not statistically
significant. Sexual risk taking in those receiving the
intervention was reduced from 75% (pre intervention) to 32%
(follow-up). |
| McCusker J, Stoodard
AM et al. (1992) AIDS Education for Drug Abusers: Evaluation of
Short-term Effectiveness. American Journal of Public Health
82(4): 533-540. |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| In drug tx |
Massachusetts. 567 clients in a
21-day inpatient drug detoxification program. 67% male, 81%
white. Blocked randomization. Group 1: standard AIDS education
program typically provided in treatment settings, consisted of
two 1-hour group sessions given early or late in tx involving
video, lectures, homework, discussion, and demonstrations of
condom use and of cleaning drug equipment. Group 2: enhanced
intervention, six 1-hour group sessions and a 30 min individual
health education consultation that focused on personal
susceptibility, situational analysis and skills-building. |
Authors disappointed in results.
Reduction in risky drug use reported by all groups. Only
significant result: enhanced group reported significantly
greater reduction in injection frequency than did group 1. |
| Schilling RF, EL-Bassel
et al. (1991) Building Skills of Recovering Women Drug Users to
Reduce Heterosexual AIDS Transmission. Public Health Reports
106(3): 297-304. |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| Women/ POC |
91 African-American and Hispanic
women enrolled for at least 3 months in five clinics in large
methadone maintenance program in NYC. Non-peer led
skills-building groups held five 2-hour sessions offered to
groups of 9-10. Topics included: HIV 101; identification of
high-risk sexual practices; discussion of barriers to adopting
safer sex practices; discussion of negative associations with
condoms; condom use skills; role-played negotiation of condom
use; assertiveness; problem solving; and communication skills
involving safer sex scenarios. Comparison group received one
session of AIDS information routinely provided by the clinic. |
The skill-building intervention
group showed statistically significant higher use of condoms
than those in the control group at follow-up. Participants also
more comfortable taking and carrying condoms, talking about
safer sex with partners, had more favorable attitudes toward
condoms. No drug use differences between groups.
Comment:
Initial follow-up was 2-week post. |
| Harris, R., Kavanagh.
S., Bausell, H. (1998) An intervention for changing high-risk
HIV behaviors of African-American, drug dependent women. 12th
World AIDS Conference, Geneva 1998 [Abstract No. 13402]. |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
|
POC/Women (African-Am)
|
204 methadone-dependent,
African-American women randomized into experimental and control
groups. Experimental group participated in peer counseling and
leadership training program over an 8-week period, followed by 8
weeks of reinforcement. Program designed to reduced sexual risk
behavior, increase self-esteem, decrease depressive affect, and
increase AIDS knowledge. |
Compared to controls, experimental
group reported significant increase in numbers of safer sexual
behaviors, showed decreases in depression, and reported engaging
in more AIDS-related, community-based communication activities. |
|
Community-Level - IDU
Back to Top |
| Jamner MS, Wolitski RJ
et al. (1997) Impact of a Longitudinal Community HIV
Intervention Targeting Injecting Drug Users Stage of Change for
Condom and Bleach Use. American Journal of Health Promotion
12(1): 15-24. |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| General |
AIDS Community Demonstration
Project in Long Beach California. 3081 IDU who were sexually
active in the past 30 days or who had shared injection equipment
in the past 60 days. Peer volunteers distributed fliers
featuring role-model stories targeted to the population’s stage
of change. Fliers were packaged with bleach kits, condoms, or
both. The intervention was designed to influence behavior
through the dissemination of information, the development of
behavioral skills and the positive reinforcement of progress
toward the consistent use of condoms and bleach. (Transtheoretical
model of behavior change) |
Repeated cross-sectional sampling
with matched intervention and comparison communities. Compared
with injecting drug users in the comparison area, IDUs in the
intervention area showed a significant increase in condom use
with non-main partners. Subjects with recent project exposure had
higher stage-of-change scores for using condoms with main and
other partners and for cleaning injection equipment with bleach. |
| Rietmeijer CA, Kane MS
et al. (1996) Increasing the Use of Bleach and Condoms Among
Injecting Drug Users in Denver: Outcomes of a Targeted,
Community-level HIV Prevention Program. AIDS 10(3):
291-298. |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| General |
The AIDS Community Demonstration
Project was conducted in Denver (890 participants) and the
comparison site was Long Beach (1107 participants). Of the
total IDUs interviewed (N=1997), in Denver 89% were male, 31%
Hispanic, and 34% black. In Long Beach, 75% were male, 21%
Hispanic, and 51% black. Over a 2.5-year period, volunteers
discussed and distributed intervention kits with small-media
behavior intervention materials, role model stories, bleach kits
and condoms to the 890 high-risk IDUs in Denver on a monthly
basis. Workers received training on basic HIV/AIDS education,
role-playing interactions, methods of street approach and
non-threatening conversation, and methods of dealing with
individuals who refuse materials |
Proportion reporting consistent
bleach use to clean needles increased significantly from
baseline (20%) to early (16%) to full implementation (29%) in
the intervention city; but decreased from 22% at baseline to 12%
at early and full implementation in the comparison city. Condom
use during vaginal intercourse with occasional partner increased
significantly from 2% at baseline to 7% at early implementation
and to 24% at full implementation of the invention city and
decreased from 12% to 10% in comparison city. No change on
condom use with steady partner. |
|
Street and Community Outreach - IDU
Back to Top |
| Coyle SL, Needle RH et
al. (1998) Outreach-Based HIV Prevention for Injecting Drug
Users: A Review of Published Outreach Data. Public Health
Report 113(1): 19-30. |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| General |
Review of 36 published studies of
outreach-based HIV risk reduction interventions for out-of-tx
IDUs. Reports intervention effect on HIV related behaviors or
HIV seroincidence. Most from National AIDS Demonstration
Research (NADR) or Cooperative Agreement for AIDS
Community-based Outreach/Intervention Research Program—both
models used a standard outreach with C&T and enhanced outreach
with follow-up of counseling, role-playing, etc.). 2/3 of
interventions were street-based outreach followed by
office-based HIV C&T. |
Most results are pre-post, no
controls. Consistency of results across studies. IDUs regularly
reported follow-up reductions in 5 major risk behaviors:
stopping injecting, reducing frequency of injecting, reducing
reuse of syringes, reducing reuse of other equipment, reducing
crack use. Studies also show significant effects in 3 protective
behaviors: more frequent needle disinfecting, entry into drug tx,
and increases in condom use. |
| Latkin CA (1998)
Outreach in natural settings: the use of peer leaders for HIV
prevention among injecting drug users’ networks. Public
Health Report 113 (Suppl 1): 151-9. |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| POC (African-Am) |
Baltimore, Maryland. 36 peer
leaders trained to promote prevention among contacts within and
beyond sex and drug networks. Peer leaders participated in
10-session training groups were administered pretest and
post-test surveys. Survey data also collected from 78 of the
leaders’ risk network members.
Peer leaders had 2165 HIV
prevention interactions, of which 84% were with active drug
users. |
Peer leaders reported a significant
increase in condom use and cleaning used needles with bleach.
The leaders’ risk network members, compared with controls, were
significantly more likely to report greater needle hygiene. |
| NADR
Program (National AIDS Demonstration Research) and CA Program
(Cooperative Agreement for HIV/AIDS Community-based
Outreach/Intervention Research).
National
Institute of Drug Abuse (Adobe Acrobat, 107 pages) An
alternative
format of this publication is also available upon request. |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| Out-of-treatment injection drug
users and the non-injecting female sex partners of male IDUs |
NADR: large study carried
out from 1987 to 1991 in 29 sites across the US. Used indigenous
outreach workers to initiate risk-reduction activities on the
streets and in other settings where IDUs tend to congregate.
Basic risk-reduction activities usually involved face-to-face
communication; the provision of literature on HIV/AIDS
transmission, prevention, and treatment; and the distribution of
risk reduction materials. Outreach workers also referred drug
users to services, including drug treatment services as well as
HIV/AIDS treatment. Outreach was generally followed with
additional, structured activities, such as confidential HIV
testing and counseling and individual risk assessments. CA:
implemented in 23 U.S. sites from 1990 to 1999. Used elements of
the NADR program plus clients assigned to basic or "enhanced"
intervention services, with basic services held consistent
across sites. Outreach activities were similar to those in the
NADR program, but were defined more uniformly. The basic
intervention entailed community-based outreach as a prelude to
two education and counseling sessions, organized around optional
HIV testing and counseling to help drug users learn about their
serostatus and the behavior changes needed to reduce
transmission risks. |
Study findings indicate that the
outreach-based interventions designed and tested in the NADR and
CA programs were effective in reaching at-risk individuals and
enabling them to reduce risk behaviors and, consequently, their
risk of acquiring HIV/AIDS. Community-based outreach was found
to be an effective approach for reaching out-of-treatment drug
users, providing materials to support HIV risk reduction,
facilitating drug treatment entry and retention, providing
referrals for HIV testing and counseling, and promoting HIV risk
reduction. The consistency of results is evidence that a
strategy of community-based outreach, counseling, and education
interventions promoted beneficial drug- and sex-risk behavior
changes. |
| Siegal HA, Falck RS et
al. (1995) Reducing HIV Needle Risk Behaviors Among
Injection-Drug Users in the Midwest: An Evaluation of the
Efficacy of Standard and Enhanced Interventions. AIDS
Education and Prevention 7(4): 308-319. |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| POC (African Am) |
NADR site. 907 participants (74%
male, 75% African-Am) assigned to one of two types of standard
or enhanced intervention. Standard: a one-hour session (in the
field office) which the counselor-educator provided details on
HIV disease and modes of transmission and an instructional
session which was followed by a videotape of role plays
illustrating proper condom use and needle cleaning. Bleach and
condoms provided. Enhanced: added to the standard intervention
three one-to two-hour sessions on the pathology of HIV disease,
drug addiction and safer sex. These were delivered over a
one-month period in-group sessions of 3-5 people. All
participants received voluntary and confidential HIV
counseling/testing as well as knowledge of negative results.
|
Follow-ups 5 to 9 months after
baseline. Both interventions appeared to improve needle
practices. The enhanced intervention showed more effectiveness
in helping those with unsafe practices to become more safe, but
did not appear to be more effective at helping those practicing
safer needle practices maintain those practices. In multivariate
analysis, subjects in enhanced more likely to change from unsafe
to safe needle use. Regardless of intervention track, daily
injectors less likely to adopt safer injecting practices than
weekly or occasional injectors. |
| Wiebel WW, Jimenez A,
Johnson W et al. (1996) Risk behavior and HIV seroincidence
among out-of-treatment injection drug users: A four-year
prospective study. Journal of Acquired Immune Deficiency
Syndromes and Human Retrovirology 12: 282-289. |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| POC |
NADR site. Monitored trends in HIV
risk behaviors and seroconversion among out-of-treatment IDUs
receiving street-based outreach in Chicago. Began 1988, followed
641 HIV negative IDUs for 4 years. Intervention guided by Indigenous
Leader Outreach Model. Ex-addicts delivered HIV prevention
services targeting IDU social networks in community settings.
Collected baseline and 6 waves of follow-up interview data.
Subjects came from 3 low-income neighborhoods: African-Am,
ethnically mixed, and Puerto Rican. |
Observed HIV incidence decreased,
from 8.4 to 2.4 per 100 person-years. Prevalence of drug risk
behaviors (sharing needles or equipment without disinfecting)
decreased, from 100% to 14%. Sex risk behavior (multiple
partners, sex with an IDU, or not always using condoms)
decreased, from 71% to 45%. |
|
Intervention Combination - IDU
Back to Top |
| Kipke MD, Edgington R
et al. (1998) HIV Prevention for Adolescent IDUs at a storefront
needle exchange program in Hollywood, CA. Presented at the 12
The World AIDS Conference, Geneva Switzerland. Abstract
#23204. |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| Youth (24 and under) |
Needle exchange targeting young
IDUs, which contains, art programming, peer-support groups, HIV
testing and case management (largest youth NEP in the US). |
Over 70% of clients reported no
needle sharing in the last 30 days, and young people who used
the NEP on a regular basis were less likely to share needles. |
| Nyamathi AM, Flaskenis
J et al. (1994) Evaluation of Two AIDS Education Programs for
Impoverished Latina Women. AIDS Education and Prevention
6(4): 296-309. |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| POC Women drug using/homeless |
The purpose was to evaluate and
contrast the effectiveness of two culturally sensitive AIDS
education programs. 131 women participated in the traditional
program where they received one hour of AIDS education and
community resource information. 82 women participated in a
specialized program where the information was extended to
include reinforcement of risk skills and enhancement of
self-esteem and control |
Over the two-week interval,
significant improvements were found in both groups for all
cognitive and psychological variables, except problem-focused
coping. High-risk IV drug use (in those who reported this
behavior during the pre test) decreased from 18 to 7 in the
traditional group and from 14 to 0 in the specialized group.
Likewise, reports of non-IV drug use and sexual activity with
multiple partners decreased in both groups.
Concern: Very short follow-up. |
| Powers B, Penn S et
al. (1990) AIDS Risk Reduction Among Female IVDUs and female
sexual partners of IVDUs, 1988-1989. VI International
Conference on AIDS 6, 421. |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| Women |
Female IDU and female sex partners
of IDUs contacted via street outreach were reached individually
(4, 724) or in groups (7,829). The intervention was to study the
‘early’ and ‘late’ outreach efforts compared to reports of
participants in ‘safer sex workshops.’ Other outreach efforts
included provision of condoms and needles, referrals, group and
individual counseling and client advocacy.v |
In early workshops, 15% reported
regularly or always using condoms; in later workshops, this
increased to 50% (no statistical analysis). |
| Tross S, Abdul-Quader
AS et al. (1993) Evaluation of a Peer Outreach HIV Prevention
Program for Female Partners of Injecting Drug users (IDUs) in
New York City. IX International Conference on AIDS 9,840. |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| Women |
658 Female sex partners of IDU
residing in a high use housing project. Peer outreach/media
distribution of flyers containing risk reduction strategies of
actual peer models occurring in 2 randomly selected housing
projects. Two non-intervention housing projects provided a
comparison sample. |
At follow-up, there was no change
in condoms use or intention to use condoms in the comparison
sample, while the intervention sample showed increased
percentage always using condoms (18% to 30%) and decrease
percentage never using condoms (46% to 27%). |
|
HIV
Antibody Counseling & Testing - IDU
Back to Top |
| Casadonte P, Des
Jarlais D. (1990) Psychological and Behavioral Impact among
Intravenous Drug Users of learning HIV test results. The
International Journal of Addiction 25(4): 4 09-426. |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| POC |
81 drug users tested and informed
of HIV positive results. |
Giving positive test results were
associated in decrease in sex (60%) at a 10 week follow up and
more condom and less drug use |
| Higgins DL, C
Galavotti et al. (1991) Evidence for the Effects of HIV Antibody
Counseling and Testing on Risk Behaviors. Journal of American
Medical Association 266(17): 2419-2429. |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| |
A review of 12 studies on the
effects of C/T on behavior change (needle use, cleaning of
needles and condoms use) of injection drug users (actual study
reviews several populations). |
From the 12 studies the results
were: 50% of the studies showed some increase in needle hygiene;
42% showed decrease in needle or drug use; 25% showed increase
in condom usage and, 17% showed decrease sexual partners. |
| Neaigua A, Sufian M et
al. (1990) Effects of Outreach intervention on risk reduction
among IDU. AIDS Education and Prevention 2(4): 253-271. |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| POC |
276 IDU were reached by street
educators who were ex-addicts, provided easy referral for HIV
testing. No control group. |
4.5-month follow-up. Drug use in
last 30 days decreased, times injected decreased; 84% tested –
half not return for results. |
| Higginbotham, S.,
Holmes, R., Stone, H., Beil, J., Datu, Costa, S., G.B., Paul,
S., (2000) Adoption of Protective Behaviors Among Persons With
Recent HIV Infection and Diagnosis--- Alabama, New Jersey, and
Tennessee, 1997--1998. MMWR June 16, 2000/49(23); 512-515 |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| |
To examine risk behaviors (e.g.,
condom use and number of sex partners) after HIV diagnosis, CDC
analyzed data on HIV Testing history and sexual behavior of
persons who may have recently acquired HIV infection as part of
a CDC sponsored study in Alabama, New Jersey, and Tennessee.
For purpose of the study, criteria for recent HIV infection
included persons with diagnosed and reported HIV infection with
CD4 T-lymphocyte counts >700 cells/ul or percentage>36,
documented HIV seroconversion within 18 months of confirmed HIV
infection diagnosis, or persons aged 13-24 years when
diagnosed. During January 1997 through September 1998, 615
persons with HIV infection diagnosed and reported met the
criteria for the study. These persons represented 15% of all
persons reported with HIV in the three states. Prior to
diagnosis, the females reporting having vaginal sex with males
and males reporting anal sex with males 25% reported never using
a condom, 69% reported sometimes using a condom, and 6% reported
always using condoms |
Of the 543 persons eligible after
follow-up, 180 persons completed the interview within 12 months
of the self-reported date learning they were HIV infected
(median: 6 months). Among those, 99 (55%) were female; 96 (53%)
were <25 years old; and 105 were non-Hispanic blacks, 49 were
non-Hispanic white, 24 were Hispanic, and two self reported as
“other”. 162 (90%) responded that they had changed their
behavior since learning of their HIV infection. After
diagnosis, the females reporting having vaginal sex with males
and males reporting anal sex with males, 30% reported not having
sex, 6% reported never using a condom, 11% reported sometimes
using a condom, and 47% reported always using condoms. The
number of sexual partners for the males and females decreased as
well. |
| Further information
can be found in
The Revised
Guidelines for HIV Counseling, Testing, and Referral (Adobe
Acrobat, 110 pages) published by the CDC. An
alternative
format of this publication is also available upon request. |
|
Partner Notification - IDU
Back to Top |
| Giesecke J, Ramstedt
K, Granath F, Ripa T, Rado G, Westrell M (1991). Efficacy of
partner notification for HIV infection. Lancet 338(8775):
1096-1100. |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| IDU |
Stockholm, 1989-1990. 365 infected
patients (91% of those diagnosed in Sweden during the interval)
named 564 needle-sharing or sexual partners. |
390 located, 350 with known test
results. 50 new seropositives identified. |
| Levy JA, Fox SE (1998)
The Outreach-assisted Model of Partner Notification with IDUs.
Public Health Report 113(S-1): 160-9. |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| General |
Chicago. 386 IDU participated. 63
(16%) tested HIV positive; 60 post-test counseled. Randomized to
"self-tell" vs. "enhanced" groups. |
In "self-tell" group marginal
locating information given for at least 142 (50% injecting, 25%
sex, 25% both). 82% of IDU in the "enhanced" group wanted the
outreach worker to do the partner notification, and 70% of
partners notified were done by outreach staff. IDUs wanted
assistance in partner notification and were cooperative. |
| Partner Counseling and
Referral Services to Identified Persons with Undiagnosed
HIV---North Carolina. MMWR December 5, 2003/52 (48);
1181-1184 |
|
Subpopulation |
Researched Intervention Design |
Evaluated Outcome |
| |
In 1989, North Carolina Department
of Health and Human Services began offering PCRS to clients who
tested positive in confidential and anonymous testing venues.
HIV infection became reportable in 1990 and anonymous testing
was discontinued in 1997. A trained disease intervention
specialist (DIS) completed six important steps. All notified
partners received risk reduction counseling and appropriate
referrals. |
Data collected from 2001 revealed a
total of 1,603 persons were newly reported to have HIV
infections. DIS were assigned to conduct PCRS with 1,580 (99%)
index clients, 1,378 (87%) were located and PCRS identified
1,532 sex or needle sharing partners. 1,359 partners were
located and notified of their possible exposure to HIV. After
PCRS, from those who not previously testing positive for HIV,
108 newly tested partners were diagnosed HIV positive. |
|
CDC Technical Guidance for Partner Notification and Referral
Services
Procedural Guidance for Implementation of Partner Notification
and Referral Services (Adobe
Acrobat, 33 pages) An
alternative
format of this publication is also available upon request. |
|
No reviews on Mass &
Other Media, Social Marketing, Hotlines, and Clearinghouse for
HIV Positive Persons. |
|
|
| |
|
No
reviews on Mass & Other Media, Social Marketing, Hotlines, and
Clearinghouse for IDU |
HIV/AIDS
Prevention and Education Services
