Increasing scientific literature and the NIH call for studies to test the translation of evidence-based risk reduction interventions into real-world contexts (Type II translation) in order to bridge the gap between research and practice to improve public health, and especially to reduce health disparities and inequities among disadvantaged groups. HIV, hepatitis, and other sexually-transmitted infections (STIs) remain significant threats to the health and well being of people with heroin and cocaine addictions, and have direct implications for their social networks, sex partners, and other community members.
We recently completed a community trial of the Risk Avoidance Partnership (RAP) (HIV Prevention in High-Risk Drug Use Sites: Project RAP; Longitudinal Study of the RAP Peer Intervention for HIV Prevention), a successful peer-delivered intervention designed to prevent HIV/hepatitis/STI risk among not-in-treatment drug injectors and crack users. These studies demonstrated the efficacy of RAP to diffuse prevention intervention through networks of active drug using Peer Health Advocates (PHAs), resulting in significant reduction in illicit drug use and drug-related risk behaviors among PHAs and their drug-using network members. Further, RAP intervention exposure was associated with entry into drug abuse treatment, improved attitudes toward risk reduction and health promotion, and increased drug-user empowerment and engagement in risk/harm reduction efforts in their neighborhoods/communities and with their peers. Strong evidence of the project’s efficacy when tested in a community research setting suggests the importance and timeliness of moving it to real-world applications.
The goal of this 3-year translation study, is to modify RAP for use in drug treatment clinics by training clinic patients as PHAs, and to pilot test the modified intervention design. This study will lay the foundation for a subsequent study to test implementation of RAP in drug treatment clinics. ICR is partnering with Hartford Dispensary (HD) to conduct this translational intervention study.
This study is a follow-up to previous projects,HIV Prevention in High-Risk Drug Use Sites: Project RAP, and Longitudinal Study of the RAP Peer Intervention for HIV Prevention.