Reducing HIV/AIDS and Drug Abuse: Linking Compulsory Rehabilitation to Methadone

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DESCRIPTION (provided by applicant): China faces the challenge of dual epidemics of drug use and HIV/AIDS. Despite the high relapse rate among addicts released from compulsory rehabilitation facilities, there are few programs available in China to assist these addicts in the community. Studies conducted in the United States and other countries have shown that methadone maintenance treatment (MMT) is effective in reducing drug use and HIV risks among heroin addicts. We propose to develop and pilot-test a Recovery Management Intervention (RMI) to allow early detection of relapse and prompt linkage of addicts released from compulsory rehabilitation to community-based MMT upon relapse. Shanghai has a well-established social worker consortium funded by the government to assist drug addicts in the community, which provides a unique testing ground for the proposed intervention. By developing and implementing RMI via the social worker network, the proposed study addresses an urgent need for reducing HIV/AIDS in China and is likely to have a great and long-lasting impact on improving the successful transition of addicts released from the rehabilitation facilities to the community. The proposed project has the following primary aims: 1) to engage key stakeholders in the local communities involved in supporting the transition of heroin addicts released from compulsory rehabilitation to the community; 2) to identify potential barriers for participating in MMT in China; 3) to develop and deliver educational/training materials on HIV risks, relapse prevention, and MMT; 4) to adapt and develop the Recovery Management Intervention program for addicts released from compulsory rehabilitation in China; 5) to conduct a pilot trial and obtain preliminary outcome data associated with RMI, relative to standard care; and a secondary aim: 6) to explore predictors of relapse and HIV/AIDS risk behaviors. The program to be developed and the data collected in the proposed study will establish a basis for a future, larger trial on effectiveness of the intervention program. If proven effective, the program can be widely applied in China and in other parts of the world to reduce heroin use and related HIV risk behaviors.