Positive Prevention for HIV+ Injection Drug Users Kelly Knight, Debra Allen, Caryn Pelegrino, Kelly Knight, Debra Allen, Caryn Pelegrino,

Barbara Garcia and Jeff MooreBarbara Garcia and Jeff Moore

Collaborators

CCynthia A. Gómez, PhD - P.Iynthia A. Gómez, PhD - P.I University of California, San Francisco University of California, San Francisco

Centers for Disease Control &PreventionCenters for Disease Control &Prevention Project Officers:Project Officers:

David Purcell, JD, PhDDavid Purcell, JD, PhDScott Santibanez, MD, PhDScott Santibanez, MD, PhD

Richard Garfein, PhDRichard Garfein, PhD

Heath Services and Resources AdministrationHeath Services and Resources Administration(HRSA)(HRSA)

Project Officer:Project Officer:Bob Netty, PhDBob Netty, PhD

Johns Hopkins UniversityJohns Hopkins UniversityCarl Latkin, PhD - P.I Carl Latkin, PhD - P.I

New York Academy of MedicineNew York Academy of MedicineMary Latka, PhD - P.I.Mary Latka, PhD - P.I.

University of Miami, FloridaUniversity of Miami, FloridaLisa Metsch, PhD - P.I.Lisa Metsch, PhD - P.I.

University of California, San FranciscoUniversity of California, San FranciscoKelly Knight, M.Ed - Co-Investigator,Kelly Knight, M.Ed - Co-Investigator,Project DirectorProject DirectorPaula Lum, MD, MPH - Co-Paula Lum, MD, MPH - Co-Investigator Investigator Carol Dawson-Rose - PhD, RN, Co-Carol Dawson-Rose - PhD, RN, Co-InvestigatorInvestigatorSonja Mackenzie, MPH - Evaluation Sonja Mackenzie, MPH - Evaluation Co.Co.

VOICE STUDY GOALS:

• Reduce HIV transmission to HIV uninfected sexual and drug use partners;

• Increase access to and use of HIV primary health care;

• Increase access and adherence to HIV treatments.

* National name = INSPIRE

From VENUS to VOICE

• VENUS Study: Qualitative 1998-99

• What are the psychological and social contexts of HIV and HIV transmission among HIV+ IDUs?

• How are sex and relationships impacted by HIV among HIV+ IDUs?

• What type of prevention interventions would work for HIV+ IDUs?

VENUS Qualitative Findings

• Cycle of HIV Integration

• Social contexts of HIV

• Contexts of Sexual and Drug Use Transmission

• HIV Disclosure and Responsibility

• Peer Support and Mentoring

VOICE Methods

• Randomized Controlled Trial with longitudinal follow up

• HIV+ IDUs were recruited from each of the four sites (N=966)

• Baseline and 3- 6- and 12-month follow-up surveys assess sex and drug use risk behaviors, access to and utilization of HIV care and adherence to HIV medications

• CD4 and Viral Load Tests at Baseline, 6- and 12-Month visits

• Follow-up is still on-going through Winter, 2005.

VOICE Intervention• Peer Mentor Intervention:

– Seven group sessions, two individual sessions, and one Peer Volunteer Activity at a community agency

• Video Discussion Intervention:

– 8 group sessions based on watching and discussing videos on a range of topics including criminal justice system, overdose, disclosure of HIV to children

Disclosure to Sexual Partners

• Activity from the Peer Mentor Intervention– Facilitated by Barbara Garcia and Jeff Moore

Facilitator Impressions

• How did VOICE meet the needs of HIV+ IDUS?

• What worked well?

• What were the challenges in delivering a positive prevention to IDUs?

The Peer Volunteer Activity

• Innovative activity in a behavioral research study

• Goal of expanding the social roles of HIV+ IDUs and increasing their service knowledge

• Agencies hosted active users and gave them productive roles in the agency service delivery structure

The VOICE PVA: Research-Community Collaboration

• Establishing PVA sites

• Preparing participants and making a good match

• Follow-up and maintenance of PVA relationships

The Take Home Message Acknowledge the psychological and social

contexts of HIV

Open dialogue about sex and relationships

Skills building related to HIV responsibility

System integration

Peer support and HIV mentorship