Designing interventions to prevent HIV-1 infection by promoting use of condoms and spermicides among intravenous drug abusers and their sexual partners
Stone, A.J.; Morisky, D.; Detels, R.; Braxton, H.
Aids Education and Prevention Official Publication of the International Society for Aids Education 1(3): 171-183
1989
ISSN/ISBN: 0899-9546 PMID: 2641239 Document Number: 360310
Participants at a 2-day workshop convened by the University of California, Los Angeles School of Public Health in May 1988, at the request of the Contraceptive Evaluation Branch of the National Institutes of Child Health and Human Development, discussed the feasibility of interventions aimed at promoting use of condoms and spermicides among intravenous drug abusers and their sexual partners. Such interventions are crucial to child survival efforts since the major source of human immunodeficiency virus (HIV) transmission to children is from infected intravenous drug abusers. Although most intravenous drug abusers have casual sexual contacts, over 90% are in a long-standing relationship. Contraception is more likely to be used by drug addicts in casual sexual encounters than in their stable sexual relationship. Participants at the workshop reached the consensus that intervention programs should target the couple (even if 1 partner is not an intravenous drug user), use existing value systems to change behavior, have a warm and entertaining tone, and obtain community support. Among the strategies that have been effective in recruiting intravenous drug abusers and their sexual partners have been advertisements, use of sites such as family planning and community health centers, use of nonmedical service locations such as day care centers and community organizations, involvement of trained volunteers, and targeting of a high-risk housing project. Since many intravenous drug abusers are members of poor minority communities with a history of degrading contact with institutions, attention must be given to securing the trust of participants. The interventions themselves should use behavioral modification methods that leave existing values and roles intact. In general, peer group meetings are most successful in inducing a commitment to initiate and maintain new sexual behaviors.