Project Neighborhoods in Action: An HIV-related intervention project targeting drug abusers in Washington, DC

Abstract

Project Neighborhoods in Action was a human immunodeficiency virus (HIV) outreach and intervention program that was conducted with injection drug users and crack users in several inner-city neighborhoods in the District of Columbia. Study participants were placed randomly in either a standard intervention or an enhanced intervention condition, with more than 800 persons being assigned to each group. Drug use frequency dropped from 15.2 days to 12.4 for alcohol (P <.0001), 2.1 days to 1.6 for marijuana (P < .003), 13.0 days to 8.8 days for crack (P < .0001), 2.4 days to 1.5 days for cocaine (P < .0001), 19.7 days to 15.6 for heroin (P < .0001), and 5.2 days to 3.4 for speedball (P < .0001). Drug injecting decreased from an average of 90.8 times to 66.9 (P < .0001), with both direct sharing and indirect sharing rates decreasing significantly as well (from 2.4 to 1.1 times for the former [P < .002] and from 12.0 to 8.1 times for the latter [P < .0004]). The number of sexual partners dropped from a mean of 1.6 to 1.1 (P < .0001). The number of drug-injecting sexual partners went from 0.3 to 0.2 (P < .01). Having sex while high decreased from 11.2 times to 7.9 (P < .0001). Trading sex for drugs and/or money declined from 1.9 times to 1.3 (P < .001). Protected sex increased from 29.5% to 63.7% (P < .0001), and the number of unprotected sexual acts dropped from 9.6 to 7.2 (P < .0001). Only a few differences were observed for standard versus enhanced intervention respondents, with no particular pattern formed. We were left with the impression that the standard intervention and enhanced intervention used in this program were about equally effective at reducing the involvement of drug abusers in HIV-related risky behaviors.

Predictors of Condom-Related Attitudes among At-Risk Women

“…Research on the efficacy of educational sessions and interventions including these types of exercises has shown them to be effective at increasing proficiency and decreasing related HIV risk behaviors. 49,50 Related to this, a third way to alter people's attitudes toward condom use would be to target their overall sense of condom use self-efficacy. If people can be made to feel confident in their ability to use condoms correctly and confident in their ability to convince otherwise reluctant partners to use condoms, they will be less apt to feel that they want to avoid using condoms and more likely to engage in lowered-risk behaviors than their counterparts who lack such confidence in themselves and their abilities.…”

‘It’s not what you know but who you know’: Role of social capital in predicting risky injection drug use behavior in a sample of people who inject drugs in Baltimore City

“…This inventory has been shown to have good concurrent and predictive validity and internal consistency [Hoffman, et al, 1999]. …”

“…These studies have found a number of social network characteristics to be associated with the individual’s drug use behavior. Characteristics identified have included having a high-frequency injector in one’s network [Trotter, Baldwin & Bowen, 1995], perceptions of needle sharing among peers [Neaigus, 1996], closed networks and networks with kinship ties [Latkin, 1995], larger network size and density of drug using network [Suh, et al, 1997; Schröder, 2001; Latkin, 1996], injecting at friends’ residences [Hoffman, 1999], having a current steady sexual relationship with a partner who is a PWID and high network turnover [Van Ameijden, 1994]. …”

Cocaine Use and the Utilisation of Drug Help Services by Consumers of the Open Drug Scene in Hamburg

“…They revealed on the one hand the expected interaction between the decrease in high-risk sexual behaviour and the decrease in drug use, and on the other hand the necessity to focus on the patterns of use prevailing in the respective target group and not on individual substances when implementing help programmes [19,28,29].…”