Interventions for seropositive injectors-research and evaluation: an integrated behavioral intervention with HIV-positive injection drug users to address medical care, adherence, and risk reduction.
BACKGROUND
Behavioral interventions to address the complex medical and HIV risk reduction needs of HIV-seropositive (HIV-positive) injection drug users (IDUs) are urgently needed. We describe the development of Interventions for Seropositive Injectors-Research and Evaluation (INSPIRE), a randomized controlled trial of an integrated intervention for HIV-positive IDUs, and the characteristics of the baseline sample.


METHODS
HIV-positive IDUs were recruited from community settings in 4 US cities. After completing a baseline assessment, participants who attended the first session were randomly assigned to (1) a 10-session peer mentoring intervention designed to improve utilization of HIV care, to improve adherence to HIV medications, and to reduce sexual and injection risk or (2) an 8-session videotape control. Periodic follow-up for 12 months is ongoing.


RESULTS
A total of 1161 HIV-positive IDUs completed the baseline assessment, and 966 (83%) were randomized. Retention rates are greater than 80% for all follow-up periods. Approximately 79% of baseline participants reported a recent medical visit, 49% were taking highly active antiretroviral therapy, and 19% had an undetectable viral load. Use of injection and noninjection substances was prevalent, and sexual and injection risks were each reported by more than 25% of participants.


CONCLUSIONS
There is a need for an integrated intervention for HIV-positive IDUs, and these data show the acceptability of such an approach.
Purcell
David W
DW
Division of HIV/AIDS Prevention, National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. dpurcell@cdc.gov
Metsch
Lisa R
LR
Latka
Mary
M
Santibanez
Scott
S
Gómez
Cynthia A
CA
Eldred
Lois
L
Latkin
Carl A
CA
D004522:Educational Status; D004651:Employment; D005260:Female; D015658:HIV Infections / Q000517:prevention & control* / Q000523:psychology / Q000635:transmission*; D006679:HIV Seropositivity / Q000523:psychology / Q000635:transmission*; D006801:Humans; D007182:Income; D008297:Male; D008611:Mentors; D010349:Patient Compliance; D010353:Patient Education as Topic / Q000379:methods; D018579:Patient Selection; D040242:Risk Reduction Behavior; D012309:Risk-Taking; D012725:Sexual Behavior; D015819:Substance Abuse, Intravenous / Q000517:prevention & control / Q000523:psychology*; D014481:United States; D014743:Videotape Recording