@article{714676fd1116424a94b5b1bb6bca65dd,
title = "AIDS prevention programs for intravenous drug users: Diversity and evolution",
abstract = "Recent studies show AIDS risk reduction among intravenous drug users in response to a wide variety of prevention programs. These prevention programs have ranged from simple education to the provision of drug abuse treatment. Case studies of three programs that have been in operation for relatively long times-in Amsterdam, New Jersey and New York-show evolutionary changes. The programs have to respond to the needs of their clientele as well as concerns of the political environment. The changes are often in directions radically different from the original expectations of the program designers. A unifying theme in these changes is that programs providing treatment to reduce drug injection and programs providing means for 'safer' injection should be seen as complementary rather than contradictory.",
author = "{Des Jarlais}, {Don C.}",
note = "Funding Information: There are currently four AIDS outreach programs for IV drug users in New York City. While there are basic similarities across the programs-all use ex-addict outreach workers-there are also differences in emphases. The programs started at different times, and reflect the thinking of the developers and funding agencies at the time the program started as well as some changes that have occurred over time. Shortly after the outreach program was begun in New Jersey, a similar program was implemented in New York City. The program was operated by Narcotic and Drug Research, Incorporated, under funding from the New York State Department of Health. The original purpose of the program was to provide AIDS education and easy access to HIV antibody testing. Ex-addict outreach workers were sent into high drug use neighborhoods with educational materials. In addition to providing education about AIDS, the outreach workers provided information about antibody testing. Current IV drug users who were interested in antibody testing were immediately escorted to an alternate test site, where they would receive pre-test counseling, and, if they desired, an HIV antibody test. This system was devised in order to overcome the problems foreseen with IV drug users trying to use the regular alternate test site system, which often requires telephoning for an appointment, and then having to appear at the specified later time. (Street IV drug users are not particularly good at either making or keeping appointments.) While the antibody testing component of this outreach program has remained relatively constant over time, there has been considerable change in the AIDS education component. The initial plan was to have outreach workers spend a limited amount of time, approximately 3 months, in a specific area of the city and then move to another area. This would permit the greatest coverage of the different high drug use areas in the city. The AIDS education component also currently includes some distribution of bleach for de-contaminating used injection equipment. A strategy of targeting a specific area for short term, high visibility AIDS education efforts was developed by ADAPT, the second group to begin AIDS outreach efforts for IV drug users in the city. (ADAPT is an organization developed by ex-addicts and interested health professionals. It is funded primarily by the City Department of Health.) The strategy involves flooding a specific location for a single day with large numbers of volunteer outreach workers, drawing the attention of large numbers of IV drug users and other community residents to the AIDS-IV drug use problem. ADAPT also pioneered the strategy of placing bleach in shooting galleries for use in de-contaminating used injection equipment. Funding Information: A third outreach effort in New York, funded by the National Institute on Drug Abuse, is operated by NDRI with a subcontract to ADAPT. This effort involves long term presence of outreach workers in a single area and establishing groups of active IV drug users to promote change towards AIDS risk reduction from within the IV drug use community. A fourth outreach effort, operated by NDRI with funding from the Centers for Disease Control also involves the long term presence of outreach workers in a single area, distribution of small bottles of bleach for de-contaminating used injection equipment, and emphasizes behavior change for preventing heterosexual transmission of HIV. Copyright: Copyright 2014 Elsevier B.V., All rights reserved.",
year = "1989",
doi = "10.3109/09540268909110387",
language = "English (US)",
volume = "1",
pages = "101--108",
journal = "International Review of Psychiatry",
issn = "0954-0261",
publisher = "Informa Healthcare",
number = "1-2",
}