Testing a Community-Friendly Risk Reduction Intervention for Injection Drug Users

• Changes in HIV Risk Behaviors [ Time Frame: Over a 12-month period ] [ Designated as safety issue: No ]
  HIV risk-reduction knowledge, motivation, and self-reported risky behavior will be measured via ACASI (Audio Computer Assisted Self Interview), a computer-based assessment instrument.
  
  

• Patient evaluation of treatment [ Time Frame: Over a 12-month period ] [ Designated as safety issue: No ]
  A patient evaluation of treatment form will be completed at the end of the intervention and at follow-up by all patients, with ratings of patient's satisfaction with the intervention, the degree of change of their condition, and perception of helpful or harmful aspects of the intervention they received.
  
  

• Frequency of drug use [ Time Frame: Over a 12-month period ] [ Designated as safety issue: Yes ]
  Patients will be screened via urine toxicology tests to determine use of illicit opiates and cocaine bi-weekly and at pre-, post-, and all 3 follow-up assessments. Patients also will report amount and frequency of drug use via computerized questionnaire at pre-, weekly, post-, and all 3 follow up assessments.
  
  
• HIV informational, motivational, and behavioral skills [ Time Frame: Over a 12-month period ] [ Designated as safety issue: Yes ]
  Subjects will be asked to report the number of sex partners they had and the number of times in the past month they engaged in sexual intercourse and the number of times condoms were used. Drug-related items will require participants to categorize and quantify their drug use during the prior month. Both data points will be collected via a computer-based assessment instrument. Behavioral skills, including condom applications and syringe cleaning will be assessed via demonstrations with replicas.
  
  
• Self-reported drug craving and aversion and HIV-risk behavior knowledge [ Time Frame: Over a 12-month period ] [ Designated as safety issue: Yes ]
  Patients will self-report their drug cravings using a computerized questionnaire. Weekly quizzes will be given with immediate feedback to further assess their knowledge of HIV-risk behavior.
  
  
• Social Support [ Time Frame: Over a 12-month period ] [ Designated as safety issue: No ]
  A social support questionnaire will be completed at pre-, post-, and follow-up measurement points. This measure consists of 15 items designed to assess perceived social support. Items from this widely used scale include availability of support and validation of support.
  
  

This research study will test the effects of CHRP, a community-friendly risk reduction intervention, which is based on the Information-Motivation-Behavioral Skills model of health behavior change (IMB; Fisher & Fisher, 1992), and, thus, is designed to enhance knowledge, motivation, and behavior skills for reducing drug- and sex-related HIV risk behaviors. Outcomes assessed will include urine toxicology screens, self-reported HIV drug- and sex-related HIV risk behavior, HIV/AIDS knowledge, risk reduction motivation, and risk reduction behavioral skills.

To measure the effects of CHRP, the investigators are proposing a two-condition (standard of care plus the CHRP intervention vs. standard of care plus a time-and-attention matched control condition) randomized design, balancing for participant gender. The investigators will assess participants at baseline, immediately post-intervention, and at 3-, 6-, and 12-month measurement points following the intervention. This assessment approach will allow the investigators to examine the trajectory of HIV risk reduction change including the decay or emergence of intervention effects.