Drug User Intervention Trial (DUIT)

Investigators: Richard S. Garfein, PhD, MPH, Steffanie Strathdee, Ph.D, Lawrence Ouellet, PhD, Sharon Hudson, PhD, Mary Latka, PhD, Holly Hagan, PhD, Hanne Thiede, DVM, MPH, Elizabeth Golub, PhD, Marie Bailey-Kloch, Karen Yen-Hobelman, PhD, Susan Bailey, PhD, Joyce Fitzgerald, Peter Kerndt, MD, MPH, Karla Wagner, PhD, David Vlahov, PhD, Farzana Kapadia, PhD, Nadine Snyder, BA, Jennifer V. Campbell, MPH, David Purcell, PhD, JD, Ian Williams, PhD, Paige Ingram, RN, Andrea Swartzendruber, MPH

DUIT is a small-group, clinic-based, behavioral intervention that aims to reduce risky injection and sexual behaviors among injection drug users who are HIV and HCV negative. During six 2-hour sessions, two trained health advisors promote group cohesion and peer education within the DUIT group. The health advisors also encourage behavior change by teaching peer-education tactics, risk-reduction strategies, and safer sex and injection negotiation skills. Ultimately, the DUIT program increases participants. perceived risk of HIV/HCV, their motivation to practice safer injection and sexual behaviors, their knowledge of risky behaviors, and key risk-reduction strategies. Click here to view more detailed information on this program.

Protect and Respect

Investigators: Michelle Teti, Linda Lloyd, Susan Rubinstein, Lisa Bowleg, Mary Ann Nkansa, Russell Cole, Zekarias Berhane, Erika Aaron, Ann Ricksecker, Marla Gold, Susan Spencer, Rhonda Ferguson, Dianne Rorie

PROTECT AND RESPECT, a clinic-based, behavioral intervention, aims to reduce the sexual transmission of HIV by decreasing high-risk behaviors among women living with HIV/AIDS. The intervention delivers HIV prevention messages in the following three ways: (1) a primary care provider counsels participants during health care visits; (2) an Intervention Specialist leads five group skills building sessions that teach skills to reduce sexual risk behaviors; and (3) Peer Educators conduct weekly discussion groups, which support participants. attempts to implement behaviors learned in the group skills building sessions. The program provider delivers a one-time, brief prevention message lasting 3 . 5 minutes, while the group skills building sessions consist of five 2-hour weekly educational sessions delivered over a 5-week period. The peer-led support groups meet weekly for 1-hour, beginning after the group skills building sessions have concluded, and may extend for as long as the program is in effect. During support group sessions, women are provided with an opportunity to discuss specific topics such as HIV risk reduction strategies, how to disclose, handling stress, or communicating with partners. Click here to view more detailed information on this program.

Point for Point

Investigators: San Francisco AIDS Foundation HIV Prevention Project & The Prevention Point Research Group

Point for Point is a needle exchange intervention designed for implementation in street settings. Needle exchange operates on the premise that increased availability of sterile syringes can reduce the prevalence of needle-sharing among injection drug users (IDUs). Needle sharing, the use of the same syringe by more than one person, is associated with high rates of transmission of infectious diseases, including HIV/AIDS. Point for Point relies on trained volunteers to operate exchange sites at which sterile hypodermic syringes are exchanged for used syringes on a one-for-one basis. Volunteers also distribute condoms and provide exchangers with bleach, alcohol swabs, sterile cotton, and other materials associated with safer drug-injection techniques. Point for Point was evaluated under the name Prevention Point in connection with the Urban Health Study (UHS), a long-term study of the IDU community in San Francisco, CA. Data collected through UHS surveys revealed that Point for Point quickly became the principal source of sterile syringes for San Francisco IDUs, and that IDUs who reported regular use of the needle exchange were significantly less likely to report needle-sharing than IDUs who did not use the needle exchange. Participants also reported a significant drop in the median number of daily injections, and the proportion of respondents who reported their first injection behavior in the previous year dropped significantly. An overall decline in reported needle sharing was also observed (Watters, 1996; Watters, Estillo, Clark and Lorvick, 1994). Click here to view more detailed information on this program.

Holistic Health Recovery Program for Injection Drug Users (HHRP)

Investigators: S. Kelly Avants, PhD, Arthur Margolin, PhD, Mary Helen Usubiaga, MD, Cheryl Doebrick, PhD

HOLISTIC HEALTH RECOVERY PROGRAM FOR INJECTION DRUG USERS is a 12-session, manual-guided, group therapy intervention delivered over six weeks. This risk reduction and health promotion intervention is appropriate for use with drug users in a substance abuse treatment program, and it was designed to specifically address the special needs of HIV-negative and status unknown injection drug users (IDUs). HHRP is based on the Information-Motivation-Behavioral Skills (IMB) model of HIV prevention through behavioral change and uses cognitive remediation components to facilitate learning and retention of IMB treatment components. The primary goals of this intervention are harm reduction, health promotion, and improved quality of life. More specific objectives include abstinence from illicit drug use or from sexual risk behaviors, reduced drug use, reduced risk of HIV infection, and improved medical, psychological, and social functioning. The HHRP program includes session topics such as: reaching your goals; health care participation; reducing the harm of injection drug use; harm reduction with latex; negotiating harm reduction with partners; preventing relapse to risky behavior; healthy lifestyle choices; introduction to the 12-steps; overcoming stigma; motivation for change; emotional and spiritual healing; and healthy social relationships and activities. Click here to view more detailed information on this program.

Let's Chat

Investigators: Seth C. Kalichman

Let’s Chat is a four-session intervention designed for use with same-sex groups of adults with chronic mental illness. Based on the Information-Motivation-Behavioral (IMB) Skills Model, Let’s Chat addresses risk-reduction needs specific to persons with mental illness. In each of the 90-minute sessions, a team of two facilitators conveys important AIDS-prevention information, alternating lectures and video clips with role-play and group-participation activities. Participants discuss sexual pressure and coercion, practice negotiating condom use, and learn the proper method for using both male and female condoms. All four sessions place emphasis on clear, simple messages and useful skills practice. Click here to view more detailed information on this program.

Project SMART: AIDS Education for Drug Users in Short-Term Treatment

Investigators: Benjamin Lewis

Developed for use in short-term in-patient drug treatment programs, Project SMART includes two distinct interventions: a two-session informational intervention and a six-session enhanced intervention that includes both informational and behavioral skills training. A trained health educator delivers both interventions. In the informational intervention, participants receive an overview presentation about AIDS, complete homework, and watch condom-use and works-cleaning demonstrations. In the enhanced intervention, participants also participate in role-plays, watch video presentations, and practice condom-use and works-cleaning skills. Click here to view more detailed information on this program.

Turning Point

Investigators: Russel S. Falck, Robert G. Carlson, & Harvey A. Siegal

Turning Point includes two separate interventions designed to reduce the frequency and probability of injection-risk behavior among IDUs not participating in drug abuse treatment programs. The basic intervention consists of two sessions. In the first session, participants undergo HIV antibody tests and receive pre-test counseling. In the second session, a counselor-educator provides detailed information about HIV and HIV transmission and guides the participant group through activities intended to teach behavioral strategies for avoiding exposure to HIV. Participants in the enhanced intervention complete the basic intervention and attend three additional sessions, in which they address HIV/AIDS pathology, drug addiction, and safer sex practices. Both interventions employ videotape presentations, role-play, hands-on demonstrations, and print materials. The enhanced intervention also employs slide presentations, self-assessment tests, and lecture/discussion. The program's effectiveness was evaluated in Dayton and Columbus, OH. Participants were randomly assigned to one of the two interventions. Surveys were administered to both groups at enrollment and six months after the intervention. A majority of participants in both the standard and enhanced interventions reported safer needle practices at follow-up. Although no difference in needle risk was observed between intervention groups when all subjects were included in analyses, participants in the enhanced intervention who reported unsafe needle practices at enrollment were significantly more likely to report safer needle practices at follow-up than similar participants in the standard intervention (Siegal, Falck, Carlson and Wang, 1995). Click here to view more detailed information on this program.

Multimedia WiLLOW Training Modules

Investigators: Lucy Baden & Josefina J. Card

These multimedia, interactive training modules will help you train for and implement the intervention Multimedia WiLLOW: HIV Transmission Reduction Among African American Women Living with HIV. Multimedia WILLOW in an interactive computer-based intervention designed for African American women living with HIV that is gender relevant and culturally sensitive, based on the effective group intervention WiLLOW. The intervention incorporates elements of sexual risk reduction to reduce STI/HIV sexual transmission and to enhance psychosocial mediators and structural factors associated with preventive behaviors. The Multimedia WiLLOW training contains 6 modules, and covers important information and skills for administrators and facilitators. The modules contain videos, quizzes, and interactive learning exercises. Over the course of the training, the modules cover topics such as: program background and information; the original implementation(s) of the program; benefits and challenges of computer-delivered interventions; and other uses of the program.

WILLOW: HIV Transmission Reduction Among Women Living with HIV

Investigators: Wingood, GM, DiClemente, RJ, MikHail, I, Lang, DL, Hubbard McCree, D, Davies, SL, Hardin, JW, Hook, EW & Saag, M

Traditional methods of preventing the transmission of STIs and HIV/AIDS focus on decreasing risk behaviors while increasing condom usage among individuals who are HIV negative. Included in those methods are individual counseling and group interventions. Few risk reduction interventions are developed specifically for women who have tested positive for HIV, despite data that indicate that a growing number of women acquired their infections through heterosexual contact. WILLOW was designed as a group intervention for African American women. The intervention incorporates elements of sexual risk reduction and social networking to reduce STI/HIV sexual transmission and to enhance psychosocial mediators and structural factors associated with preventive behaviors over a one-year period. The evaluation of WILLOW was a randomized controlled study including 366 women who were assigned to either the intervention (n=190) or comparison (n=176) conditions. Criteria for eligibility included: HIV+ serostatus; aged 18-50; and sexually active during the past six months. Following a baseline assessment, women were randomly assigned to one of two conditions. Follow-up assessments were conducted at six and twelve months post intervention. Over the 12-month follow-up period, women in the intervention group, as compared to their comparison group counterparts, reported fewer incidents of unprotected vaginal intercourse (1.8 vs. 2.5; P=0.022); were less likely to report never using condoms (OR=0.27; P=0.008); had a lower rate of bacterial infections (OR=0.19, P=0.006); reported greater HIV knowledge and condom use self-efficacy, more network members, fewer beliefs that condoms interfere with sex, and fewer partner-related barriers to condom use; and demonstrated greater skill in using condoms. Click here to view more detailed information on this program.

The SISTA Project

Investigators: Ralph DiClemente & Gina Wingood

SISTA, a gender-relevant, culturally sensitive group program for African-American women, is designed to be implemented in a community setting. Based on social cognitive theory and the theory of gender and power, SISTA seeks to prevent HIV transmission by promoting consistent condom use. Peer Health Educators lead five two-hour sessions, focusing first on ethnic and gender pride, then moving on to provide knowledge about HIV/AIDS and skills training to promote sexual safety. Each session employs group discussion, lecture, role play activities and written homework to increase retention of risk reduction strategies. Click here to view more detailed information on this program.