National HIV Prevention Conference Atlanta, Georgia, USA — August 29- September 1, 1999

Natl HIV Prev Conf 1999 Aug 29-Sep 1:(abstract no. 102)
Carl A. Latkin, Ph. D, Johns Hopkins School of Public Health

BACKGROUND: To rigorously test behavioral outcomes of peer network outreach intervention. The study used random assignment, an equal attention control group, interviewers blind to participants' condition, pre-and post-test of controls, complete documentation of the 10 session intervention protocol, and extensive quantitative and ethnographic process evaluation.

METHODS: Index individuals were a street sample randomly assigned 2-to-1 either an outreach condition or an equal attention control condition. Pre-and post-assessments of the indexes and randomly chosen risk network members were conducted. We are conducting pre-and post-test in-depth interviews with 10% of the sample, and ethnographic observations of group sessions and community outreach.

RESULTS: We screened 1,070 individuals; of these 367 brought in network members and 224 agreed to participate in the intervention and showed up for random assignment. Of the 224 who participated in the intervention 91%graduated (completed at least 80%of the sessions). We have had a 3-month follow-up rate of 86%.

Behavioral outcomes: Sixty-two percent of the first 118 index participants were male. The needle hygiene data were collected from 49 participants who reported injecting in the prior 6 months. Sexual behaviors, based on 76 index participants, reported having had vaginal, oral, or anal sex in the prior 90 days. Even with the limited sample size, preliminary analysis revealed differences between the two groups. Significantly associated with being in the experimental compared to the control include: frequency of sharing rinse water (MH X2=19.4, p<. 05); frequency of talking to family member about HIV (X2=5.5, p<. 05); frequency of talking to acquaintances about HIV (X2=9.2, p<. 01); and feeling able to influence others to clean needles (X2=8.4, p<. 05). Marginally associated with being in the outreach condition included: feeling comfortable talking about condoms (X2 =4.7, p=.09); frequencies of condom use with main partner for vaginal sex (MH X2=8.5, p=. 07); sharing cookers (MH X2=14.9, p=06); using a syringe to divide drugs (MH X2=9.8, p=. 08); talking to drug users about HIV (X2=7.6, p=055); and talking to sex partners about HIV (MH X2=9.6, p=. 08).

Outreach encounters: Participants were encouraged to fill out a brief half-page survey that described each of their outreach contacts. Out of the first 1710 surveys, contacts were 82% first time encounters, 52% males, 60% aged 25-40 (15% under 25 years), and 23% strangers. For 53% of contacts outreach participants reported knowing the contacts 'drug use, including 719 were reported to inject, 210 to smoke crack, and 119 to snort heroin or cocaine. Topics reported to have been discussed included: needle hygiene HIV risks (70%), sexual HIV risks (79%), accessing health care (16%), HIV/AIDS treatments (25%), shelters (l0%), and needle exchange (8%). The following materials were reported to have been distributed to contacts: HIV pamphlets (43%), condoms (82%), and kits containing condoms and injection hygiene equipment (32%).

CONCLUSIONS: The results suggest that among IDUs peer network outreach is an effective strategy.

PRESENTER CONTACT INFORMATION:
Name: Carl A. Latkin, Ph. D.
Address: Associate Professor
Department of Health Policy and Management
Johns Hopkins School of Public Health
624 N. Broadway St.
Baltimore, Md. 21205
Telephone: 410-955-3972
Fax: 410-955-7241
E-mail: clatkin@jhsph.edu

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Centers for Disease Control and Prevention. National HIV Prevention Conference, 1999. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, August 29- September 1, 1999.

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