Positive Lifestyles Using Safety

Project PLUS is an HIV risk reduction/Highly Active Antiretroviral Therapy (HAART) adherence
behavioral intervention for persons being released from prisons in Connecticut. The
intervention is delivered one-on-one to HIV-infected individuals prior to release from
incarceration (Group 1) vs. after release from incarceration (Group 2) vs. treatment as
usual (Group 3). The primary hypothesis is that the intervention groups (Groups 1 & 2) will
demonstrate significantly greater reduction in rates of HIV sexual and drug risk behaviors
and a significantly greater increase in HAART adherence compared to Group 3 participants at
4 months following release from prison. (However, those in Group 3 may come back to
participate in the educational sessions, as non-study participants, after their
participation has been completed). Based on the IMB model of health behavior change, the
primary outcomes of interest are HIV risk reduction knowledge, motivation, behavioral skills
(Fisher & Fisher, 1992) and specific event-level partner-by-partner drug and sex risk
outcomes including the frequency of unprotected sex episodes across different partners
categorized by perceived HIV-status of each partner, numbers of different sexual partners,
changes in the frequency of condom use, changes in reported adherence to HIV medication, and
changes in reported drug use episodes across different partners categorized by perceived
HIV-status of each partner. Additional outcomes of interest include greater knowledge
regarding drug- and sex- related HIV risk behaviors and HAART adherence, greater motivation
to reduce HIV risk behaviors and improve HAART adherence, enhanced skills for engaging in
HIV risk reduction behaviors and HAART adherence. A comparison between Groups 1 & 2 has
never been examined, so an important part of this study is to explore this comparison.

Inclusion Criteria:

- Are 18 years of age or older

- Meet DSM-IV criteria for opioid-dependence

- Are scheduled to be released from prison within the next 30 days

- Are confirmed to be HIV-infected

- Report drug- or sex-related HIV risk behavior prior to incarceration

- Are willing to provide locator information

- Able to read and understand the questionnaires and consent form

- No minimum duration of incarceration

- Available for the full duration of the study with no anticipated circumstances
impeding participation (e.g., pending court case or warrant).

Exclusion Criteria:

- Have an untreated bipolar or psychotic disorder

- Suicidal or homicidal ideation