THE LONG-TERM IMPACT OF A NETWORK OUTREACH INTERVENTION

Summary

Principal Investigator: CARL A contact LATKIN
Abstract: DESCRIPTION (Adapted from Applicant's abstract): This is a proposal to evaluate the long term outcomes of the SHIELD study, a network-oriented, experimental HIV prevention intervention for African American injection drug users (IDUs). Based on social influence framework with theories of social diffusion and social identity, the intervention used peers as change agents to introduce safer sex and drug norms to their social networks. The study is designed to empirically examine social processes, such as norm formation and peer influence, hypothesized to explain intervention outcomes. 224 current and former drug users were trained in the 10-session intervention. Index participants were randomly assigned to either a peer outreach or an equal-attention control condition. The indexes and their peer network members were administered pre-intervention and 3-month post intervention assessments, which will complete September 1999. Preliminary analysis of 118 participants suggests that indexes in the peer outreach condition reported fewer risk behaviors and more HIV-related discussions at the 3-month follow-up. We are requesting support to conduct 12-month, 18-month, and 24-month follow-up assessments to determine the long-term effects and diffusion of effects to 934 study participants, as well as non-participating eligible individuals for comparison. In addition to assessing long-term outcomes of the SHIELD study, we seek to identify characteristics of effective peer educators, individuals for whom the intervention was most beneficial, and factors that predict relapse of risk behaviors. We also propose to conduct urine-based screening of 3 sexually transmitted infections (STIs): gonorrhea, chlamydia, and trichomonas. In addition to their health sequelae, STIs are risk factors for HIV infection and transmission, are biological markers of HIV-related sexual behavior, and help validate self-reports of risk behaviors. The data will also used to examine associations between characteristics of sex partners and personal networks to describe sexual mixing patterns of this population.
Funding Period: 2000-08-01 - 2004-07-31
more information: NIH RePORT

Top Publications

  1. 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
  2. pmc Friendship networks of inner-city adults: a latent class analysis and multi-level regression of supporter types and the association of supporter latent class membership with supporter and recipient drug use
    Amy S B Bohnert
    VA National Serious Mental Illness Treatment Research and Evaluation Center, Ann Arbor, MI, USA
    Drug Alcohol Depend 107:134-40. 2010
  3. pmc Informal care and reciprocity of support are associated with HAART adherence among men in Baltimore, MD, USA
    Amy R Knowlton
    Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
    AIDS Behav 15:1429-36. 2011
  4. ncbi Caregiver role overload and network support in a sample of predominantly low-income, African-American caregivers of persons living with HIV/AIDS: a structural equation modeling analysis
    Mary M Mitchell
    US Army Public Health Command, Aberdeen Proving Ground Edgewood Arsenal, APG EA, Aberdeen, MD 21010, USA
    AIDS Behav 16:278-87. 2012
  5. pmc The relationship between social network factors, HIV, and Hepatitis C among injection drug users in Chennai, India
    Carl Latkin
    Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
    Drug Alcohol Depend 117:50-4. 2011
  6. pmc Main partner factors associated with worse adherence to HAART among women in Baltimore, Maryland: a preliminary study
    Amy R Knowlton
    Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
    AIDS Care 23:1102-10. 2011
  7. 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
  8. pmc Experiencing violence as a predictor of drug use relapse among former drug users in Baltimore, Maryland
    Cui Yang
    Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
    J Urban Health 88:1044-51. 2011
  9. pmc Religiosity and HIV-related drug risk behavior: a multidimensional assessment of individuals from communities with high rates of drug use
    Veena G Billioux
    Department of Epidemiology, Johns Hopkins School of Public Health, 615 N Wolfe Street, Baltimore, MD, 21205, USA
    J Relig Health 53:37-45. 2014
  10. 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

Scientific Experts

Detail Information

Publications25

  1. 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. ..
  2. pmc Friendship networks of inner-city adults: a latent class analysis and multi-level regression of supporter types and the association of supporter latent class membership with supporter and recipient drug use
    Amy S B Bohnert
    VA National Serious Mental Illness Treatment Research and Evaluation Center, Ann Arbor, MI, USA
    Drug Alcohol Depend 107:134-40. 2010
    ..We hypothesized that the most supportive network members and their support recipients would be less likely to be current heroin/cocaine users...
  3. pmc Informal care and reciprocity of support are associated with HAART adherence among men in Baltimore, MD, USA
    Amy R Knowlton
    Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
    AIDS Behav 15:1429-36. 2011
    ..Results suggest the merit of interventions targeting men and their informal caregivers, particularly main partners, and gender-specific, contextually tailored strategies to promote HAART adherence...
  4. ncbi Caregiver role overload and network support in a sample of predominantly low-income, African-American caregivers of persons living with HIV/AIDS: a structural equation modeling analysis
    Mary M Mitchell
    US Army Public Health Command, Aberdeen Proving Ground Edgewood Arsenal, APG EA, Aberdeen, MD 21010, USA
    AIDS Behav 16:278-87. 2012
    ..Interventions should address the support needs of HIV caregivers to reduce their potential for distress...
  5. pmc The relationship between social network factors, HIV, and Hepatitis C among injection drug users in Chennai, India
    Carl Latkin
    Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
    Drug Alcohol Depend 117:50-4. 2011
    ..The purpose of this study was to examine whether social network factors predict HIV and Hepatitis C (HCV) serostatus after controlling for individual-level factors at baseline among a cohort of male injection drug users in Chennai, India...
  6. pmc Main partner factors associated with worse adherence to HAART among women in Baltimore, Maryland: a preliminary study
    Amy R Knowlton
    Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
    AIDS Care 23:1102-10. 2011
    ..Seroconcordant couples-focused intervention that enhances mutual support of HAART adherence may be an effective approach to improving women's HAART adherence and reducing US gender disparities in HIV health outcomes...
  7. 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...
  8. pmc Experiencing violence as a predictor of drug use relapse among former drug users in Baltimore, Maryland
    Cui Yang
    Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
    J Urban Health 88:1044-51. 2011
    ..Addressing the extent of recent violence among drug treatment participants, providing coping skills, and reducing community violence are strategies that may address the link between violence and drug relapse...
  9. pmc Religiosity and HIV-related drug risk behavior: a multidimensional assessment of individuals from communities with high rates of drug use
    Veena G Billioux
    Department of Epidemiology, Johns Hopkins School of Public Health, 615 N Wolfe Street, Baltimore, MD, 21205, USA
    J Relig Health 53:37-45. 2014
    ..Future work to understand the nature of these associations will assist in the development of interventions in communities with high rates of drug use. ..
  10. 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...
  11. pmc A social network perspective on heroin and cocaine use among adults: evidence of bidirectional influences
    Amy S B Bohnert
    VA Ann Arbor National Serious Mental Illness Treatment Research and Evaluation Center 11H, 2215 Fuller Road, Ann Arbor, MI 48105, USA
    Addiction 104:1210-8. 2009
    ..The present study sought to examine two competing theories (social selection and social influence) in the longitudinal relationship between drug use (heroin and/or cocaine) and social network drug use among drug-experienced adults...
  12. pmc High prevalence of HIV, HIV/hepatitis C virus coinfection, and risk behaviors among injection drug users in Chennai, India: a cause for concern
    Sunil S Solomon
    Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
    J Acquir Immune Defic Syndr 49:327-32. 2008
    ..To estimate the prevalence of HIV and hepatitis C virus (HCV) and hepatitis B virus (HBV) coinfections and current risk behaviors among HIV-positive and -negative injection drug users (IDUs) in Chennai, India...
  13. pmc Drug use in the social networks of heroin and cocaine users before and after drug cessation
    Amy S Buchanan
    Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, United States
    Drug Alcohol Depend 96:286-9. 2008
    ..28 for quitters at follow-up (all p<0.05). These findings support social control theory in adult drug use cessation. Future research should extend the length of follow-up and assess bidirectional influences...
  14. ncbi Calling emergency medical services during drug overdose: an examination of individual, social and setting correlates
    Karin E Tobin
    Johns Hopkins Bloomberg School of Public Health, 1629 East Baltimore Street, Baltimore, MD, USA
    Addiction 100:397-404. 2005
    ..The purpose of this study was to examine individual, social and setting correlates of calling the emergency number, 911, during an overdose...
  15. pmc Attitudes of Emergency Medical Service providers towards naloxone distribution programs
    Karin E Tobin
    Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21231, USA
    J Urban Health 82:296-302. 2005
    ..Incorporating information about substance abuse and harm reduction approaches in continuing education classes may improve the attitudes of provider toward naloxone training programs...
  16. ncbi The association between change in social network characteristics and non-fatal overdose: results from the SHIELD study in Baltimore, MD, USA
    Karin E Tobin
    Johns Hopkins Bloomberg School of Public Health, 1629 East Baltimore Street, Baltimore, MD 21231, USA
    Drug Alcohol Depend 87:63-8. 2007
    ..Yet, few studies have examined how changes in social network characteristics may influence overdose risk. The purpose of this study was to examine the relationship between changes in social network and non-fatal overdose...
  17. pmc HIV seropositive drug users' attitudes towards partner notification (PCRS): results from the SHIELD study in Baltimore, Maryland
    Karin E Tobin
    Department of Health, Behavior and Society, Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD, USA
    Patient Educ Couns 67:137-42. 2007
    ..To assess the attitudes of HIV seropositive current or former drug users towards HIV partner counseling and referral services (PCRS) and to determine if opinion varies by partner type...
  18. pmc Neighborhood socioeconomic status, personal network attributes, and use of heroin and cocaine
    Chyvette T Williams
    School of Public Health, University of Illinois at Chicago, Chicago, Illinois 60612, USA
    Am J Prev Med 32:S203-10. 2007
    ..This study investigates the effects of neighborhood disadvantage and network factors on current heroin and cocaine use among a predominantly African-American adult sample residing in Baltimore City...
  19. 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...
  20. 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...
  21. pmc Externalizing behaviors among children of HIV seropositive former and current drug users: parent support network factors as social ecological risks
    Amy Knowlton
    Department of Health, Behavior and Society, Johns Hopkins University, Bloomberg School of Public Health, 624 North Broadway, Room 286, Baltimore, MD 21205, USA
    J Urban Health 85:62-76. 2008
    ..While dually affected children's contact with their parents may have important benefits, results suggest it presents ongoing needs for intervention with the children, their parents, and caregivers...
  22. 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...
  23. ncbi Evaluation of the Staying Alive programme: training injection drug users to properly administer naloxone and save lives
    Karin E Tobin
    Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, 2213 McElderry Street, Second Floor, Baltimore, MD 21205, USA
    Int J Drug Policy 20:131-6. 2009
    ....
  24. ncbi The role of depressive symptoms in predicting sex with multiple and high-risk partners
    Chyvette T Williams
    Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
    J Acquir Immune Defic Syndr 38:69-73. 2005
    ..57, CI: 1.11, 2.22) and crack users (odds ratio = 1.37, CI: 1.02, 1.86). Findings support greater attention to depressive symptoms in HIV prevention interventions for illicit drug users to reduce sexual risk behaviors...