The Institute for Community Research (ICR) has received a 3-year grant from the National Institute on Drug Abuse (NIDA) to continue an innovative program in which participants partner with ICR staff to prevent the spread of HIV in Hartford.  From 2001-2005, ICR’s Risk Avoidance Partnership (RAP), also funded by NIDA, trained drug users to promote safer behavior by distributing prevention messages and materials to their drug-using peers in some of the city’s riskiest settings.  Now, the continuation project will evaluate the long-term effects of this peer-delivered intervention and identify ways to make it more sustainable. 

Crack cocaine and injection drug use both contribute significantly to the spread of HIV, as many drug users engage in risky acts like unprotected sex while high, sex for crack exchanges, and sharing of injection equipment.  During two years of the initial study, RAP trained 120 drug users to encourage their peers to engage in safer behavior.  While talking to other drug users about ways to reduce their HIV risk, these Peer Health Advocates pass out materials such as bleach for cleaning needles and condoms for safer sex.  “The harm reduction framework is based on the premise that not everybody is at the point in their life when they can make the best change possible,” says Margaret Weeks, Ph.D., Executive Director of ICR and Principal Investigator of the RAP continuation project.  “But there’s still the possibility for them to take some action to reduce their risk and contribute positively to their community.” 

According to Dr. Weeks, many of the Peer Health Advocates have internalized RAP’s harm-reduction messages, leading them to practice what they preach in their own drug use, and in some cases, to stop using drugs altogether.  When participants become health advocates, they take on new identities as leaders among their peers.  This experience, which ICR researchers identify as a role change, also encourages other people to see them in a new, more positive light. 

Sustaining RAP’s success through the new continuation project entails supporting the Peer Health Advocates as they seek to improve their lives and the places they live.   ICR will continue to sponsor monthly meetings of the Community Advocacy Group, which comprises participants who attended at least 5 training sessions and who have practiced delivering the intervention to other drug users.  The meetings are an opportunity for Peer Health Advocates to build their prevention knowledge, practice their presentation skills, socialize, stock up on prevention materials, and discuss issues they consider to be important in their communities. 

ICR researchers will document the Community Advocacy Group’s meetings as one way of measuring the project’s sustainability.  To evaluate RAP’s long-term effects on the trained Peer Health Advocates and the people to whom they have delivered the intervention, project staff will interview the original participants and their old and new network contacts.  They will also conduct observations of community locations in which the program was delivered to assess impacts of the peer intervention.  In the RAP continuation’s third year, researchers will conduct a community-wide survey with 500 active drug users, investigating the larger environment of drug and sex related HIV risk in Hartford. 

Peer Health Advocates will discuss their experiences at April’s HIV Forum, to take place at ICR, 2 Hartford Square West (146 Wyllys St) on Tuesday, April 11, 2006 from 12 to 1:30 pm.  For more information please contact Peg Weeks at (860) 278-2044 x229.

The Institute for Community Research is an independent, nonprofit organization that conducts applied research and community enhancement programs to promote equal access to health, education, and cultural resources. Longitudinal Study of the RAP Peer Intervention for HIV Prevention is funded by the National Institute on Drug Abuse (NIDA) 1 R01 DA13356.

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