Holistic Health Recovery Program for Injection Drug Users Living with HIV (HHRP+)

Investigators: S. Kelly Avants, PhD, Arthur Margolin, PhD, Lara A. Warburton, PhD, Keith A. Hawkins, PsyD, Julia Shi, MD

HOLISTIC HEALTH RECOVERY PROGRAM FOR INJECTION DRUG USERS LIVING WITH HIV 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-positive 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 risk for HIV transmission, reduced drug use, 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; moving beyond grief; and healthy social relationships and activities. Click here to view more detailed information on this program.

Safety Counts: A Cognitive-Behavioral Intervention to Reduce HIV/Hepatitis Risks among Drug Users Who Are Not in Drug Treatment

Investigators: Michele Wood, Jonny Andía, Gricel Arredondo, Nan Corby, Jason Farrell, Camilla Harshbarger, Gary MacDonald, Sharon Novey, Kevin O’Connor, Fen Rhodes, Paul Simons, James Testaverde, & the Centers for Disease Control and Prevention (CDC)

The Safety Counts program is a proven intervention for out-of-treatment drug-using persons that will enable them to reduce their risk of becoming infected with or transmitting the human immunodeficiency virus (HIV) and hepatitis viruses such as hepatitis C. The Safety Counts intervention is appropriate for HIV-positive as well as HIV-negative drug users. Safety Counts is based on research that found this intervention to be effective in reducing high-risk sex and drug-use behaviors among both injection and noninjection drug users. As such, it is recommended for implementation by community-based organizations (CBOs) serving drug users. Through structured group and individual activities, the intervention assists clients in setting personal risk reduction goals and developing specific steps for achieving them. In partnership with behavioral counselors and outreach workers, clients design and manage their personalized goals for reducing their risks of acquiring or transmitting HIV and viral hepatitis. Ongoing support for achieving risk reduction goals is provided through sustained contact with program staff, interactions with peers who are enrolled in the program, and exposure to the personal stories of other drug users in the local community who have been successful in reducing their own risks. Clients participate in the intervention for a period of 4 months. This client-centered intervention benefits the client and the community. The research showed that the intervention reduced HIV risks by reducing drug use, increasing condom use, and increasing self-reported entry into drug treatment. Clients benefit from the strong outreach component of Safety Counts and from referrals to medical and social services. For HIV-positive clients, Safety Counts may allow them to deal with issues beyond substance use and HIV, such as addressing risk behaviors that can lead to contracting hepatitis and other infections. All clients learn how to make positive changes in their lives through setting specific goals and developing action steps to achieve their goals. These skills empower clients to take charge of their own risk behaviors, thereby benefiting themselves, their partners, their families, and their communities.

Social Influences on the Sexual Behavior of Youth at Risk for HIV Exposure, 1992

Investigators: Daniel Romer

The study Social Influences on the Sexual Behavior of Youth at Risk for HIV Exposure: 1992 was conducted to aid in the design of HIV prevention-related interventions in poor urban minority communities. A computerized personal interview was administered to 300 African-American children aged 9-15 living in six public housing developments in a large U.S. city. The interview elicited information on several themes including: social support, parental supervision, perceived risk exposure, and self-reported behavior and feeling. This data set includes information on 94 variables from a sample of 300 respondents. Interviews were conducted during March through May of 1992.

Efficacy of a Standardized Acupuncture Regimen and Amitriptyline Compared with Placebo as a Treatment for Pain Caused by Peripheral Neuropathy in HIV-Infected Patients, 1993-1997

Investigators: Judith Shlay, Bob Flaws, Kathryn Chaloner, Jeffrey Cohen, David Cohn, Marjorie Dehlinger, Shauna Hillman, Mitchell Max, Carol Mesard, Jill Ramser, Patricia Reichelderfer, Jack Rouff, Catherine Salveson, James Sampson, Victoria Taylor

The Efficacy of a Standardized Acupuncture Regimen and Amitriptyline Compared with Placebo as a Treatment for Pain Caused by Peripheral Neuropathy in HIV-Infected Patients was conducted between 1993 and 1997 at 11 units of the Terry Beirn Community Programs for the Clinical Research on AIDS. The study was conducted to evaluate the efficacy of a standardized acupuncture regime and amitriptyline hydrochloride for relief of pain due to HIV-related peripheral neuropathy. 250 HIV-infected patients with lower extremity peripheral neuropathy were randomly assigned to receive either amitriptyline or placebo capsules (once a day) and either acupuncture or needles placed in control points (once or twice a week). The study was a randomized, placebo-controlled, clinical trial that lasted 14 weeks.

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.

Reaching for Excellence in Adolescent Care and Health, 1996-2000

Investigators: Basic Science and Clinical Science Groups, Adolescent Medicine HIV/AIDS Research Network

The Reaching for Excellence in Adolescent Care and Health (REACH) Project was an observational study designed to better understand HIV disease progression and co-morbidity in adolescents, with the ultimate goal of improving the health care management of adolescents living with HIV. The study sample includes both HIV infected adolescents and high-risk HIV uninfected adolescents, between the ages of 12 through 18 years, who were recruited from clinics throughout the United States during the late 1990s. The study utilized five primary methods of data collection: 1) direct face-to-face interview, 2) Audio Computer-Assisted Self-Administered Interview (ACASI), 3) medical record abstraction, 4) physical examinations, and 5) laboratory examinations. REACH includes data on 578 adolescents who were observed for an average of one and a half years, providing unique opportunities to study extensive biomedical, behavioral and psychosocial outcomes. Examples of topics covered in this data set include: Antiretroviral and contraceptive drug adherence Health-related quality of life Sexual and drug-related behaviors HIV status disclosure Social support Health care utilization Alcohol and drug treatment Physical examinations Laboratory examinations (e.g., immunologic, virologic, hormonal, cervicography, STI testing) REACH participant data are available as standard and sensitive data files. Standard data files primarily include information collected via subject data collection forms, in addition to the majority of the laboratory results. Sensitive data files include confidential subject information such as urine drug screen results, the Health Behavior Questionnaire, the ACASI, and derived variables for such data. Separate ID numbers for the standard and sensitive data files were assigned and data from these files cannot be linked without access to the linkage file decoding data or the acquisition of the merged sensitive dataset files from Sociometrics. Additionally, biologic specimens collected by the study are available for analysis. Investigators who are interested in utilizing REACH sensitive data files and/or specimens are required to submit a research proposal and IRB correspondence to Sociometrics that approves the proposal with no concerns about identifiable information or conflicts with the data.

Focus on Youth (FOY) with ImPACT

Investigators: Bonita Stanton, MD, PhD, Jennifer Galbraith, PhD, Cherri Gardner, MA, Pam Drake, PhD, James Walker, Scott Martin, Teree Jerome, Suzanne Schrag, Sarah Stevens, Charlene Foster, & the CDC Division of HIV/AIDS Prevention

Focus on Youth with Informed Parents and Children Together (ImPACT) is an HIV, STD and pregnancy prevention intervention for African-American youth ages 12–15. The intervention was updated from Focus on Kids, a community-university linked research and intervention program. The goal of Focus on Youth with ImPACT is to reduce the risk of HIV infection among youth. The researchers, led by principle investigator Bonita Stanton, M.D., worked with community members from recreation centers, housing developments, schools and government agencies in settings throughout the U.S. to reach this goal. The evaluation of the combined Focus on Kids and ImPACT interventions met the necessary criteria for the interventions identified as interventions with best evidence of efficacy by the Centers for Disease Control and Prevention’s (CDC) HIV/AIDS Prevention Research Synthesis (PRS) Project. Focus on Kids alone was identified as an intervention with promising evidence. This Focus on Youth with ImPACT edition provides updated information and more tools to facilitate implementation and increase the relevance of the program for African-American youth between ages 12 and 15 who are at risk for HIV infection. ImPACT is a 90-minute HIV prevention program for parents of African-American adolescents used in combination with Focus on Youth. ImPACT is delivered to parents/guardians and youth, one family at a time, by a health educator. It consists of basic HIV information, a culturally appropriate video documentary that stresses parental monitoring and communication, a discussion with the health educator, two guided roleplays, a parent/guardian resource guide, and a condom demonstration. It was guided by parental monitoring theory and theory of parenting (passive, authoritarian and authoritative).

Nia: A Group-Level Intervention with African American Men Who Have Sex with Women

Investigators: Seth Kalichman, University of Texas Southwestern Medical Center, Southeast HIV/AIDS Research and AIDS Survival Project, & the Centers for Disease Control and Prevention (CDC)

Nia is a group-level, video-based intervention with African American men 18 years and older, with at least six hours of content. While the original researcher split the content into two, three-hour sessions, the intervention can also be conducted as three or four sessions. The goal of the Nia intervention is to reduce sexual risk behavior among African American men who have sex with women. The sessions create a context through which men can do the following: Learn new information and affirm existing correct knowledge about HIV/AIDS, Examine their own sexual risks, Build motivation and skills to reduce their risks, and Receive feedback from others. Nia sessions are interactive meetings that have both an educational and an entertaining aspect. In addition, Nia uses factors, such as male pride, racial and sexual identity, receiving and giving respect, and maintaining sexual pleasure while reducing risk, to reinforce procedures for risk reduction. A male facilitator helps create an environment where the men are comfortable learning, while a female facilitator is present to assist with practice of making and communicating safer sex decisions and to help challenge and change negative attitudes towards women. Nia groups can be held in a variety of settings, as long as they are conducted in a private room where the men will feel comfortable enough to participate.

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.

Voluntary Counseling and Testing for Female Sex Workers (VCT Program)

Investigators: Xiaoming Li, PhD, Bo Wang, PhD, Xiaoyi Fang, PhD, Ran Zhao, MD, Bonita Stanton,MD, Yan Hong, MA, Baiqing Dong, MD, Wei Liu, MD, Yuejiao Zhou, MD, Shaoling Liang, MD, & Hongmei Yang, PhD

The VCT Program aims to increase STI/HIV testing, awareness of infection, STI/HIV knowledge, and consistent use of condoms among female sex workers in China in order to ultimately reduce rates of STI infections. The VCT Program demonstrated increases in knowledge of STI/HIV knowledge and consistent condom use, and decreases in STI incidence. The VCT Program is composed of a pre-test counseling session, STI/HIV testing, and a post-test counseling session. During the first 25-minute VCT counseling session, the counselor works with the participant to: complete a risk assessment; identify challenges related to risk reduction; create a risk reduction plan; and practice condom use skills. After the first counseling session, the participant completes STI/HIV testing. During the 20-minute post-test counseling session, the counselor shares test results and reviews treatment options and risk reduction plans. The VCT Program was originally implemented in a suburban area of Nanning in southern China with female sex workers recruited from entertainment establishments. This program's voluntary counseling and testing content and approach may be useful in increasing testing and safer sex behaviors in many different types of communities and populations. Click here to view more detailed information on this program.