The impact of the NIDA Cooperative Agreement programs on HIV risk among crack and injection drug users

Abstract

This chapter explores the impact of the National Institute on Drug Abuse (NIDA) funded by Cooperative Agreement AIDS education and prevention program on crack users and drug injectors. Data on the 5,789 participants were drawn from eight cities throughout the United States. Subjects were classified into three user groups: injectors only, crack smokers only, and crack-smoking injectors. They were interviewed at baseline and six months later at follow-up about their HIV risk behaviors which included needle-related behaviors, drug use patterns, and sexual behaviors. At baseline, subjects were assigned either to a two-session NIDA developed standard intervention or to a more elaborate and prolonged enhanced intervention which was independently developed in each of the sites. Analyses were conducted for the cities individually. Three major findings emerged from the analyses: (1) there is a relative lack of post intervention differences between the standard and enhanced interventions; (2) statistically significant and substantively meaningful changes occurred between pretest and posttest; and (3) despite meaningful reductions in risk behaviors among some users, a large percentage of these drug users continue to engage in all types of risky behaviors. Implications of these findings are discussed in the chapter.