A Network & Dyad HIV Prevention Intervention for Intravenous Drug User

Summary

Principal Investigator: CARL A contact LATKIN
Abstract: [unreadable] DESCRIPTION (provided by applicant): The goal of the proposed competing continuation study is to implement and evaluate an enhancement and modification of the SHIELD HIV prevention intervention targeting sexually active injection drug users (DA13142) to examine its efficacy, diffusion to main risk network members, and sustainability. Baltimore has some of the highest rates of injection drug use (IDU), HIV, and sexually transmitted infections (STIs) in the U.S. Interventions that are culturally competent and target drug users' main sex and drug partners may be especially effective for HIV/STI and HCV control and prevention. Grounded in a social influence framework, with theories of social diffusion, social norms, and social identity, the SHIELD intervention uses peers to promote risk reduction within their social networks. Results indicate greater reported sex and drug risk reduction and HIV advocacy with network members at 6-month follow-up among experimental compared to equal-attention control participants. The findings also suggest that the intervention had limited effect on participants' risk behaviors with their main sex partners. Based on extensive outcome and process evaluation of the SHIELD study and reviews of the literature, major changes proposed are: adding two training sessions with index participants' main risk ties to increase their receptivity to indexes' outreach messages, and incorporating booster sessions to enhance the sustainability of intervention effects. The proposed study design is a controlled phase II efficacy trial. Index participants randomly assigned to the experimental condition will be trained to conduct peer HIVIHCV education and distribute prevention materials among their main high-risk network members. Index participants (n=400; 200 per arm) will be street-recruited sexually active injection drug users who are able to recruit at least one risk network member. Indexes will be asked to recruit risk network members (average 2; 400 per arm) for intervention and assessment. One risk partner per index will be selected for recruitment for 2 dyadic intervention sessions, with priority to main sex partners; the other network members will receive only the pre- and post-assessments to measure diffusion of intervention effects. Outcome evaluation will include pre-test and 3-, 6-, 12-, and 18-month post-intervention assessment. Main outcome measures will be self-reported sex and injection risk behaviors. Self-reports will be cross-validated by urinalysis of STIs. [unreadable] [unreadable]
Funding Period: 2003-06-15 - 2009-05-31
more information: NIH RePORT

Top Publications

  1. pmc Social network structure and HIV infection among injecting drug users in Lithuania: gatekeepers as bridges of infection
    V Anna Gyarmathy
    Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
    AIDS Behav 18:505-10. 2014
  2. pmc Predictors of sharing injection equipment by HIV-seropositive injection drug users
    Carl A Latkin
    Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Room 737, Baltimore, MD 21205, USA
    J Acquir Immune Defic Syndr 49:447-50. 2008
  3. pmc Boredom, depressive symptoms, and HIV risk behaviors among urban injection drug users
    Danielle German
    Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 2213 McElderry Street, Baltimore, MD, 21205, USA
    AIDS Behav 16:2244-50. 2012
  4. pmc Norms, attitudes, and sex behaviors among women with incarcerated main partners
    Melissa A Davey-Rothwell
    Department of Health, Behavior and Society, Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD, 21205, USA
    J Urban Health 90:1151-65. 2013
  5. pmc The relationship between drug user stigma and depression among inner-city drug users in Baltimore, MD
    Carl Latkin
    Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
    J Urban Health 90:147-56. 2013
  6. pmc Injection drug users' and their risk networks' experiences of and attitudes towards drug dealer violence in Baltimore, Maryland
    Carl A Latkin
    Department of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA
    Int J Drug Policy 24:135-41. 2013
  7. pmc The dynamic relationship between social norms and behaviors: the results of an HIV prevention network intervention for injection drug users
    Carl Latkin
    Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
    Addiction 108:934-43. 2013
  8. pmc Social integration and suicide-related ideation from a social network perspective: a longitudinal study among inner-city African Americans
    S Janet Kuramoto
    American Psychiatric Institute for Research and Education, Arlington, VA, USA
    Suicide Life Threat Behav 43:366-78. 2013
  9. pmc A simulative comparison of respondent driven sampling with incentivized snowball sampling--the "strudel effect"
    V Anna Gyarmathy
    Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA Electronic address
    Drug Alcohol Depend 135:71-7. 2014
  10. pmc Social network approaches to recruitment, HIV prevention, medical care, and medication adherence
    Carl A Latkin
    Department of Health, Johns Hopkins Bloomberg School of Public Health, University of Pennsylvania, Baltimore, MD, USA
    J Acquir Immune Defic Syndr 63:S54-8. 2013

Scientific Experts

Detail Information

Publications46

  1. pmc Social network structure and HIV infection among injecting drug users in Lithuania: gatekeepers as bridges of infection
    V Anna Gyarmathy
    Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
    AIDS Behav 18:505-10. 2014
    ..These findings suggest the importance of harm reduction activities, including confidential testing and counseling, and of social network interventions...
  2. pmc Predictors of sharing injection equipment by HIV-seropositive injection drug users
    Carl A Latkin
    Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Room 737, Baltimore, MD 21205, USA
    J Acquir Immune Defic Syndr 49:447-50. 2008
    ....
  3. pmc Boredom, depressive symptoms, and HIV risk behaviors among urban injection drug users
    Danielle German
    Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 2213 McElderry Street, Baltimore, MD, 21205, USA
    AIDS Behav 16:2244-50. 2012
    ..This study demonstrates the need for more thorough understanding of mental health and HIV risk among urban drug users...
  4. pmc Norms, attitudes, and sex behaviors among women with incarcerated main partners
    Melissa A Davey-Rothwell
    Department of Health, Behavior and Society, Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD, 21205, USA
    J Urban Health 90:1151-65. 2013
    ..Interventions designed for couples at pre- and post-release from prison are needed to develop risk reduction plans and encourage HIV/STI testing prior to their reunion. ..
  5. pmc The relationship between drug user stigma and depression among inner-city drug users in Baltimore, MD
    Carl Latkin
    Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
    J Urban Health 90:147-56. 2013
    ..These programs should focus on the attitudes and behaviors of health and service providers toward drug users, among drug users themselves, and among family members and others who provide social support to drug users...
  6. pmc Injection drug users' and their risk networks' experiences of and attitudes towards drug dealer violence in Baltimore, Maryland
    Carl A Latkin
    Department of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA
    Int J Drug Policy 24:135-41. 2013
    ..A large portion of violence associated with drug use is due to drug dealing. These analyses sought to examine injection drug users' attitudes and experiences of drug dealer violence...
  7. pmc The dynamic relationship between social norms and behaviors: the results of an HIV prevention network intervention for injection drug users
    Carl Latkin
    Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
    Addiction 108:934-43. 2013
    ..This study examined changes in social norms and relationships between HIV injection risk behaviors and social norms among injection drug users (IDUs) involved in an experimental intervention...
  8. pmc Social integration and suicide-related ideation from a social network perspective: a longitudinal study among inner-city African Americans
    S Janet Kuramoto
    American Psychiatric Institute for Research and Education, Arlington, VA, USA
    Suicide Life Threat Behav 43:366-78. 2013
    ..Future research should examine the mechanisms associated with this relationship and other social network constructs. ..
  9. pmc A simulative comparison of respondent driven sampling with incentivized snowball sampling--the "strudel effect"
    V Anna Gyarmathy
    Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA Electronic address
    Drug Alcohol Depend 135:71-7. 2014
    ..Respondent driven sampling (RDS) and incentivized snowball sampling (ISS) are two sampling methods that are commonly used to reach people who inject drugs (PWID)...
  10. pmc Social network approaches to recruitment, HIV prevention, medical care, and medication adherence
    Carl A Latkin
    Department of Health, Johns Hopkins Bloomberg School of Public Health, University of Pennsylvania, Baltimore, MD, USA
    J Acquir Immune Defic Syndr 63:S54-8. 2013
    ..There are also ethical issues involved in the development and implementation of social network interventions. Social network analyses can also be used to understand HIV transmission dynamics...
  11. pmc The relationship between drug use stigma and HIV injection risk behaviors among injection drug users in Chennai, India
    Carl Latkin
    Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Baltimore, MD 21205, USA
    Drug Alcohol Depend 110:221-7. 2010
    ..The purpose of this study was to examine the relationship between perceived drug use stigma, acquiescence response bias, and HIV injection risk behaviors among current injection drug users in Chennai, India...
  12. pmc Factors associated with recruiting an HIV seropositive risk network member among injection drug users
    Carl Latkin
    Department of Health, Behavior and Society, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
    AIDS Behav 14:1137-41. 2010
    ..These results suggest the feasibility to target active drug users to recruit seropositives and emphasize the public health importance of focusing network approaches on the networks of African American IDUs...
  13. pmc Social-level correlates of shooting gallery attendance: a focus on networks and norms
    Karin E Tobin
    Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
    AIDS Behav 14:1142-8. 2010
    ..Future research is needed to understand how social networks and peer norms are specific to behavioral settings and how this may impede adoption of preventive behaviors...
  14. pmc Liquid drugs and high dead space syringes may keep HIV and HCV prevalence high - a comparison of Hungary and Lithuania
    V Anna Gyarmathy
    European Monitoring Centre for Drugs and Drug Addiction, Lisbon, Portugal
    Eur Addict Res 16:220-8. 2010
    ....
  15. pmc A dynamic social systems model for considering structural factors in HIV prevention and detection
    Carl Latkin
    Department of Health, Behavior and Society, The Johns Hopkins Bloomberg School of Public Health, 624 N Broadway, Baltimore, MD 21205, USA
    AIDS Behav 14:222-38. 2010
    ..Finally, we discuss methodological issues in the development and evaluation of structural interventions for HIV prevention and detection...
  16. pmc Infection disclosure in the injecting dyads of Hungarian and Lithuanian injecting drug users who self-reported being infected with hepatitis C virus or human immunodeficiency virus
    V Anna Gyarmathy
    European Monitoring Centre for Drugs and Drug Addiction, Lisbon, Portugal
    Scand J Infect Dis 43:32-42. 2011
    ..Ongoing free and confidential HCV/HIV testing services for IDUs are needed to emphasize and strengthen disclosure norms, and to decrease stigma...
  17. pmc The STEP into Action study: a peer-based, personal risk network-focused HIV prevention intervention with injection drug users in Baltimore, Maryland
    Karin Elizabeth Tobin
    Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
    Addiction 106:366-75. 2011
    ....
  18. pmc Sexual networks and housing stability
    Melissa A Davey-Rothwell
    Department of Health, Behavior and Society, Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD 21205, USA
    J Urban Health 88:759-66. 2011
    ..Also, having a sex partner who was a drug user was associated with decrease in the odds of improving one's housing situation...
  19. pmc Understanding subtypes of inner-city drug users with a latent class approach
    S J Kuramoto
    Johns Hopkins Bloomberg School of Public Health, Department of Mental Health, Baltimore, MD, USA
    Drug Alcohol Depend 118:237-43. 2011
    ..We empirically identified subtypes of inner-city users of heroin and cocaine based on type of drug used and route of administration...
  20. pmc Perceived serosorting of injection paraphernalia sharing networks among injection drug users in Baltimore, MD
    C Yang
    Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 2213 McElderry Street, 2nd Floor, Baltimore, MD 21205, USA
    AIDS Behav 15:16-21. 2011
    ..Future prevention efforts targeting IDUs should address the limitation of serosorting, and focus on preventing injection paraphernalia sharing regardless of potential sharing networks' perceived HIV status...
  21. pmc Does taking steps to control one's drug use predict entry into treatment?
    Melissa Davey-Rothwell
    Johns Hopkins Bloomberg School of Public Health, Department of Health, Behavior, and Society, Baltimore, Maryland 21205, USA
    Am J Drug Alcohol Abuse 35:279-83. 2009
    ..Treatment readiness has been shown to predict entry and success in drug treatment programs...
  22. pmc Social norms, social networks, and HIV risk behavior among injection drug users
    C A Latkin
    Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
    AIDS Behav 14:1159-68. 2010
    ..There were also differences based on gender. Future HIV prevention interventions for IDUs should target both injection and sex risk norms, particularly among IDUs in the multiple needle-sharing networks...
  23. pmc Longitudinal analysis of the relationship between perceived norms and sharing injection paraphernalia
    Melissa A Davey-Rothwell
    Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
    AIDS Behav 14:878-84. 2010
    ..Changing norms may lead to sustained behavior change. Accessible, norms-based interventions are needed to discourage drug injectors from sharing injection paraphernalia...
  24. ncbi Injection drug users' strategies to manage perceptions of personal risk: how do IDUs see HIV as having affected them?
    Katherine Clegg Smith
    Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA
    AIDS Educ Prev 19:245-57. 2007
    ..We argue that effective HIV prevention should explicitly acknowledge and address the stigmatized IDU identity, rather than assuming readiness for behavior change...
  25. pmc Direct and indirect associations of neighborhood disorder with drug use and high-risk sexual partners
    Carl A Latkin
    Johns Hopkins University Bloomberg School of Public Health, Department of Health, Behavior and Society, Baltimore, Maryland 21205, USA
    Am J Prev Med 32:S234-41. 2007
    ..The current study used structural equation modeling to examine the relationship between neighborhood social and physical disorder and high-risk sexual partners...
  26. ncbi Residential transience and HIV risk behaviors among injection drug users
    Danielle German
    Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
    AIDS Behav 11:21-30. 2007
    ..Further examination of the association between housing and HIV should consider the role of transience. Interventions that promote housing stability among IDUs and address HIV risk during times of instability are needed...
  27. ncbi Individual and social network factors that predict entry to drug treatment
    Melissa A Davey
    Department of Health, Behavior, and Society, Johns Hopkins University, Bloomberg School of Public Health, 1629 East Baltimore Street, Baltimore, MD 21231, USA
    Am J Addict 16:38-45. 2007
    ..29, 95% CI: 1.07-1.56] and fewer network members who smoked crack [AOR: 0.86, 95% CI: 0.75-0.99] were more likely to enter treatment. Social network-based interventions that promote successful outcomes in drug treatment are needed...
  28. ncbi Needle exchange program utilization and entry into drug user treatment: is there a long-term connection in Baltimore, Maryland?
    Carl A Latkin
    Department of Health, Behavior, and Society, Johns Hopkins, Bloomberg School of Public Health, Baltimore, MD 21205, USA
    Subst Use Misuse 41:1991-2001. 2006
    ..These findings highlight the importance of NEPs in linking injectors to treatment. These data also suggest that treatment needs to address co-occurring problems, like HIV and mental illness. Study limitations are noted...
  29. ncbi A bridge over troubled waters: factors associated with non-injection drug users having injection drug-using sex partners
    David L Howard
    Department of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA
    J Acquir Immune Defic Syndr 42:325-30. 2006
    ..To examine factors associated with noninjectors having 1 or more injection drug users as sex partners...
  30. ncbi Getting clean and harm reduction: adversarial or complementary issues for injection drug users
    James Peterson
    Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
    Cad Saude Publica 22:733-40. 2006
    ..This paper describes how the conflict was identified and what changes were made to the intervention to help resolve the participants' dichotomous thinking concerning their substance abuse issues...
  31. ncbi Micro-social structural approaches to HIV prevention: a social ecological perspective
    C A Latkin
    Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
    AIDS Care 17:S102-13. 2005
    ....
  32. pmc Gender differences in social network influence among injection drug users: perceived norms and needle sharing
    Melissa A Davey-Rothwell
    Department of Health, Behavior and Society, Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD 21205, USA
    J Urban Health 84:691-703. 2007
    ..74-1.31). These findings suggest the utility of peer education interventions that promote norms regarding risk reduction among injection drug users. The data also provide support for gender-specific HIV prevention interventions...
  33. ncbi HIV-related communication and perceived norms: an analysis of the connection among injection drug users
    Melissa A Davey-Rothwell
    Department of Health, Behavior and Society, Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD 21205, USA
    AIDS Educ Prev 19:298-309. 2007
    ..34, SE = 6.58, p = .020) were associated with belief that peers' practiced risky drug behaviors. These findings may be used to develop peer education HIV prevention interventions for drug users...
  34. pmc Relationships between social norms, social network characteristics, and HIV risk behaviors in Thailand and the United States
    Carl Latkin
    Department of Health, John Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
    Health Psychol 28:323-9. 2009
    ..In this study, the authors examined whether the social norms of HIV risk behaviors are clustered within social networks and whether the norms of network members are linked to the risk behaviors of their social network members...
  35. pmc HIV testing and conspiracy beliefs regarding the origins of HIV among African Americans
    Amy S B Bohnert
    VA National Serious Mental Illness Treatment Research Evaluation Center, 2215 Fuller Road, Ann Arbor, MI 48105, USA
    AIDS Patient Care STDS 23:759-63. 2009
    ..The finding that individuals who have conspiracy beliefs are more likely to have been tested for HIV may partially explain why HIV-positive individuals who endorse conspiracy beliefs are more likely to obtain an earlier diagnosis...
  36. pmc The efficacy of a network intervention to reduce HIV risk behaviors among drug users and risk partners in Chiang Mai, Thailand and Philadelphia, USA
    Carl A Latkin
    Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
    Soc Sci Med 68:740-8. 2009
    ..The intervention did not result in overall reductions in self-reported sexual risk behaviors, and although reductions in injection risk behaviors were observed, the overall efficacy in reducing risk was not established...
  37. pmc An examination of social network characteristics of men who have sex with men who use drugs
    K E Tobin
    Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, 2213 McElderry Street, Baltimore, Maryland 21205, USA
    Sex Transm Infect 84:420-4. 2008
    ..Specifically, we were interested in examining the differences in structure of the networks and drug and sexual risk partners within the network...
  38. pmc Residential transience and depression: does the relationship exist for men and women?
    Melissa A Davey-Rothwell
    Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 2213 McElderry Street, 2nd Floor, Baltimore, MD 21205, USA
    J Urban Health 85:707-16. 2008
    ..Stable housing and mental health services need to be available, easily accessible, and designed so that they remain amenable to utilization under transient circumstances...
  39. pmc Pathways to depression: the impact of neighborhood violent crime on inner-city residents in Baltimore, Maryland, USA
    Aaron Curry
    Surveillance Data Incorporated, Philadelphia, PA, USA
    Soc Sci Med 67:23-30. 2008
    ..We conclude that community and structural level interventions are needed to decrease neighborhood crime and improve residents' perception of their neighborhood...
  40. ncbi Social networks, norms, and 12-step group participation
    Melissa A Davey-Rothwell
    Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205, USA
    Am J Drug Alcohol Abuse 34:185-93. 2008
    ..Individuals who are trying to control their drug use should be encouraged to affiliate with others in recovery or attending a 12-step program...
  41. ncbi An examination of perceived norms and exchanging sex for money or drugs among women injectors in Baltimore, MD, USA
    M A Davey-Rothwell
    Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
    Int J STD AIDS 19:47-50. 2008
    ..Also, participants who thought their peers disapproved of sex exchange were 20% less likely to exchange sex (95% CI: 0.67-0.95). These findings suggest the need for peer education interventions that promote norms about safer behaviours...
  42. ncbi Neighborhood social disorder as a determinant of drug injection behaviors: a structural equation modeling approach
    Carl A Latkin
    Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205 1996, USA
    Health Psychol 24:96-100. 2005
    ....