Community Supported Risk Reduction for Syringe Exchange Participants
| Status: | Recruiting |
|---|---|
| Conditions: | Psychiatric |
| Therapuetic Areas: | Psychiatry / Psychology |
| Healthy: | No |
| Age Range: | 18 - 70 |
| Updated: | 1/17/2019 |
| Start Date: | May 2016 |
| End Date: | March 2019 |
| Contact: | Michael Sklar, M.A. |
| Email: | msklar1@jhmi.edu |
| Phone: | 410-550-1542 |
Social Network Intervention for Syringe Exchange Registrants
Efforts to help syringe exchange registrants employ additional HIV risk reduction strategies
are often thwarted by strong social networks that reinforce substance use and other risky
injection use and sexual behaviors. The proposed study addresses this important problem by
evaluating the feasibility and efficacy of a novel Community Supported Risk Reduction group.
This structured intervention works with injection drug users and at least one drug-free
family or friend to mobilize social support, teach HIV risk reduction skills, develop
treatment readiness, and support participation in community activities designed to expand
drug-free social networks.
are often thwarted by strong social networks that reinforce substance use and other risky
injection use and sexual behaviors. The proposed study addresses this important problem by
evaluating the feasibility and efficacy of a novel Community Supported Risk Reduction group.
This structured intervention works with injection drug users and at least one drug-free
family or friend to mobilize social support, teach HIV risk reduction skills, develop
treatment readiness, and support participation in community activities designed to expand
drug-free social networks.
Participants of syringe exchange programs routinely suffer from untreated or under-treated
substance use disorder, a situation that is associated with significant individual and public
health costs. These individuals are also routinely embedded within social networks that
reinforce continued drug use and related HIV-risk behaviors. The welfare of these individuals
and the public's health can be improved by interventions directed toward reducing drug use
risks and expanding drug-free support . Previous work by the investigators has demonstrated
that an intervention combining an HIV risk reduction/treatment readiness group with
behavioral contingencies is highly associated with increased rates of treatment enrollment
and re-engagement, and reduced rates of drug use and HIV-injection risks, for up to one year.
This protocol extends this work by adding a new component to the HIV risk reduction/treatment
readiness group designed to expand social support and facilitate social network change. This
intervention requires syringe exchange registrants to attend the group with a drug-free
family or friend from their personal network that can provide stable support and encourage
harm reduction and treatment seeking. This intervention uses an alteration network change
model and posits that repeated exposure to drug-free community support collaterally reduces
exposure to network members that support risk behaviors. This model also provides a pathway
to modifying existing social networks by facilitating interaction with the personal social
networks of drug-free family and friends. The intervention is supported by research showing
that substance users report substantial pockets of drug-free family or friends in their
social networks. It is also supported by community reinforcement principles that have shown
efficacy in treatment samples, but have not been applied to out-of-treatment drug users. The
present study has four primary aims. The first is to characterize natural drug-free support
in the social networks of syringe exchangers. The second is to develop a Community Supported
Risk Reduction group for syringe exchange participants and their community support. This
group teaches skills for HIV risk reduction, treatment seeking, and healthy network
expansion. The third and fourth aims are to obtain new data on the feasibility and efficacy
of this intervention. Primary outcomes include changes in: 1) perceived social support, and
2) HIV risk behaviors.
substance use disorder, a situation that is associated with significant individual and public
health costs. These individuals are also routinely embedded within social networks that
reinforce continued drug use and related HIV-risk behaviors. The welfare of these individuals
and the public's health can be improved by interventions directed toward reducing drug use
risks and expanding drug-free support . Previous work by the investigators has demonstrated
that an intervention combining an HIV risk reduction/treatment readiness group with
behavioral contingencies is highly associated with increased rates of treatment enrollment
and re-engagement, and reduced rates of drug use and HIV-injection risks, for up to one year.
This protocol extends this work by adding a new component to the HIV risk reduction/treatment
readiness group designed to expand social support and facilitate social network change. This
intervention requires syringe exchange registrants to attend the group with a drug-free
family or friend from their personal network that can provide stable support and encourage
harm reduction and treatment seeking. This intervention uses an alteration network change
model and posits that repeated exposure to drug-free community support collaterally reduces
exposure to network members that support risk behaviors. This model also provides a pathway
to modifying existing social networks by facilitating interaction with the personal social
networks of drug-free family and friends. The intervention is supported by research showing
that substance users report substantial pockets of drug-free family or friends in their
social networks. It is also supported by community reinforcement principles that have shown
efficacy in treatment samples, but have not been applied to out-of-treatment drug users. The
present study has four primary aims. The first is to characterize natural drug-free support
in the social networks of syringe exchangers. The second is to develop a Community Supported
Risk Reduction group for syringe exchange participants and their community support. This
group teaches skills for HIV risk reduction, treatment seeking, and healthy network
expansion. The third and fourth aims are to obtain new data on the feasibility and efficacy
of this intervention. Primary outcomes include changes in: 1) perceived social support, and
2) HIV risk behaviors.
Inclusion Criteria (for Baltimore Needle Exchange Program registrants):
- Baltimore Needle Exchange Program (BNEP) registration
- Injection heroin use
- Identifies a drug-free community support person (CSP)
- Not currently receiving substance abuse treatment
Exclusion Criteria (for BNEP registrants):
- Pregnancy
- Acute medical problem that requires urgent medical management
- Presence of a thought disorder, delusions, hallucinations, or imminent risk of harm to
self or others
- Unable to read
Exclusion Criteria (for CSPs):
- Submission of a drug-positive urine sample
- Pregnancy
- Acute medical problem that requires urgent medical management
- Presence of a thought disorder, delusions, hallucinations, or imminent risk of harm to
self or others
- Unable to read
We found this trial at
1
site
4940 Eastern Ave
Baltimore, Maryland 21224
Baltimore, Maryland 21224
(410) 550-0100
Principal Investigator: Michael Kidorf, Ph.D.
Phone: 410-550-1542
Johns Hopkins Bayview Medical Center There is no better story in American medicine in the...
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