Health Care Access

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Positive Prevention for HIV Injection Drug Users
Kelly Knight, Debra Allen, Caryn Pelegrino,
Barbara Garcia and Jeff Moore
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Collaborators

• New Jersey City University Jeff Parsons, PhD -
  P.I.
• Beatrice Krauss, PhD - Co-PI (NDRI) Alison
  Thomas-Cottingham, MA- P..D. Thomas Borkowski
• University of California, San Francisco Kelly
  Knight, MEd - Project Director Paula Lum, MD,
  MPH - Co-Investigator Carol Dawson, RN, PhDc -
  Field Coord.

Cynthia A. Gómez, PhD - P.I University of
California, San Francisco Centers for Disease
Control Prevention Project OfficersDavid
Purcell, JD, PhD Scott Santibanez, MD,
PhD Richard Garfein, PhD Heath Services and
Resources Administration (HRSA) Project
Officer Bob Netty, PhD
Johns Hopkins University Carl Latkin, PhD - P.I
New York Academy of Medicine Mary Latka, PhD -
P.I. University of Miami, Florida Lisa Metsch,
PhD - P.I. University of California, San
FranciscoKelly Knight, M.Ed - Co-Investigator, Pr
oject Director Paula Lum, MD, MPH -
Co-Investigator Carol Dawson-Rose - PhD, RN,
Co-Investigator Sonja Mackenzie, MPH - Evaluation
Co.
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VOICE STUDY GOALS

• Reduce HIV transmission to HIV uninfected sexual
  and drug use partners
• Increase access to and use of HIV primary health
  care
• Increase access and adherence to HIV treatments.
• National name INSPIRE

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From VENUS to VOICE

• VENUS Study Qualitative 1998-99
• What are the psychological and social contexts of
  HIV and HIV transmission among HIV IDUs?
• How are sex and relationships impacted by HIV
  among HIV IDUs?
• What type of prevention interventions would work
  for HIV IDUs?

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VENUS Qualitative Findings

• Cycle of HIV Integration
• Social contexts of HIV
• Contexts of Sexual and Drug Use Transmission
• HIV Disclosure and Responsibility
• Peer Support and Mentoring

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VOICE Methods

• Randomized Controlled Trial with longitudinal
  follow up
• HIV IDUs were recruited from each of the four
  sites (N966)
• Baseline and 3- 6- and 12-month follow-up surveys
  assess sex and drug use risk behaviors, access to
  and utilization of HIV care and adherence to HIV
  medications
• CD4 and Viral Load Tests at Baseline, 6- and
  12-Month visits
• Follow-up is still on-going through Winter, 2005.

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VOICE Intervention

• Peer Mentor Intervention
• Seven group sessions, two individual sessions,
  and one Peer Volunteer Activity at a community
  agency
• Video Discussion Intervention
• 8 group sessions based on watching and discussing
  videos on a range of topics including criminal
  justice system, overdose, disclosure of HIV to
  children

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Disclosure to Sexual Partners

• Activity from the Peer Mentor Intervention
• Facilitated by Barbara Garcia and Jeff Moore

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Facilitator Impressions

• How did VOICE meet the needs of HIV IDUS?
• What worked well?
• What were the challenges in delivering a positive
  prevention to IDUs?

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The Peer Volunteer Activity

• Innovative activity in a behavioral research
  study
• Goal of expanding the social roles of HIV IDUs
  and increasing their service knowledge
• Agencies hosted active users and gave them
  productive roles in the agency service delivery
  structure

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The VOICE PVA Research-Community Collaboration

• Establishing PVA sites
• Preparing participants and making a good match
• Follow-up and maintenance of PVA relationships

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The Take Home Message

• Acknowledge the psychological and social contexts
  of HIV
• Open dialogue about sex and relationships
• Skills building related to HIV responsibility
• System integration
• Peer support and HIV mentorship

VENUS