title: Outcomes of a peer HIV prevention program with injection drug and crack users: the Risk Avoidance Partnership.
abstract: The Risk Avoidance Partnership (RAP) Project conducted in Hartford, Connecticut, tested a program to train active drug injectors and crack cocaine users as "Peer Health Advocates" (PHAs) to deliver a modular HIV, hepatitis, and STI prevention intervention to hard-to-reach drug users in their networks and others in the city. The intervention was designed to diffuse health promotion and risk-reduction interventions by supporting PHAs to model prevention practices and deliver risk- and harm-reduction materials and information. We compared change in behaviors and attitudes between baseline and 6-month follow-up of 112 primarily African-American and Latino PHAs, 223 of their drug-user network contact referrals, and 118 other study recruits (total n = 523). Results indicated significant HIV risk reduction among all study participants, associated with significant health advocacy action conducted by PHAs, and a relationship between exposure to the RAP peer-delivered intervention and risk reduction among all study groups. Findings suggest that active drug users' engagement in peer health advocacy can set in motion a feedback and diffusion process that supports both the continued work of the PHAs and the adoption of harm reduction and mimicking of health advocacy by their peers.
authors.affiliation: Institute for Community Research, Hartford, Connecticut 06106, USA. mweeks@icrweb.org
authors.forename: Margaret R
authors.initials: MR
authors.lastname: Weeks
authors.forename: Jianghong
authors.initials: J
authors.lastname: Li
authors.forename: Julia
authors.initials: J
authors.lastname: Dickson-Gomez
authors.forename: Mark
authors.initials: M
authors.lastname: Convey
authors.forename: Maria
authors.initials: M
authors.lastname: Martinez
authors.forename: Kim
authors.initials: K
authors.lastname: Radda
authors.forename: Scott
authors.initials: S
authors.lastname: Clair
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003237:Connecticut; D016578:Crack Cocaine; D005260:Female; D015658:HIV Infections / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019982:Organizational Case Studies; D010379:Peer Group; D040242:Risk Reduction Behavior; D012944:Social Support; D015819:Substance Abuse, Intravenous; D055815:Young Adult
chemical_list: D016578:Crack Cocaine