Testing a Community-Friendly Risk Reduction Intervention for Injection Drug Users

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DESCRIPTION (provided by applicant): Despite a wide array of HIV prevention approaches and related research, there is a decade-long trend of 40,000 new HIV diagnoses per year in the U.S. (CDC, 2004; Copenhaver & Fisher, in press). Injection drug users (IDUs) remain a target population as they represent a significant vector for the transmission of new HIV infections (Avants et al., 2004; Margolin et al., 2003), which occur through preventable drug- and sex- related HIV risk behaviors. A number of evidence-based HIV risk reduction interventions are now widely available as complete intervention packages. However, very few evidence-based interventions have been designed for implementation within common drug treatment CBOs, such as methadone maintenance programs (MMPs), where many high-risk drug users seek treatment. Moreover, based on analogous efforts to disseminate evidence-based behavioral interventions for treating drug dependence (Morgenstern et al., 2001; Institute of Medicine, 1998), the few evidence-based interventions that are applicable to drug treatment CBOs are not designed to be "community-friendly" and are therefore unlikely to be implemented as intended or durable within these critical settings. Our team of investigators has developed a significantly shortened, community-friendly, version of the comprehensive evidence-based Holistic Health Recovery Program (HHRP; Avants et al., 2004; Margolin et al., 2003). The shortened version, the Community-friendly Health Recovery Program (CHRP), has demonstrated feasibility and acceptability as well as preliminary evidence of effectiveness in an uncontrolled study within a resource-limited drug treatment CBO (Copenhaver et al., in press; see Appendix). In this revised R01 application, we propose to evaluate CHRP in a randomized controlled trial (RCT). If found to be effective in the proposed trial, CHRP has the potential to be fully integrated, as designed, within many other resource-limited CBOs where large numbers of high risk drug users participate in drug treatment.