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 updated June 30, 2005

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St. Louis' Effort to Reduce the Spread of AIDS and IVDUs (ERSA)

Project Title	St. Louis' Effort to Reduce the Spread of AIDS and IVDUs (ERSA)
Funding Source	NIH, NIDA
Project Dates	1989 - 1994
Project Number	R18-DA06163
Team	Principal Investigators- Linda B. Cottler, Ph.D. Co-Investigator- Lee N. Robins, Ph.D. Collins Lewis, M.D. Rumi K. Price, Ph.D. Gregory A. Storch, M.D. Linda K. Sussman, Ph.D. Larry McEnvoy, M.A.
Consultants	Oval Miller, Executive Director, BASIC Myrtle Davis, President, St. Louis Comprehensive Center Larry Brown, M.D., New York

Abstract

The primary objective of this four and one half year city-wide research demonstration project is to attract an increased number of intravenous drug users (IVDUs) to enter treatment; to improve drug free and methadone maintenance treatment programs and to education persons about how to reduce behaviors associated with the spread of HIV infection. In an effort to reach IVDUs not in treatment, a community street outreach program will also be initiated. This research will be conducted in St. Louis, an area with currently low prevalence of reported AIDS cases, and high prevalence of intravenous drug use (IVDU). Specifically, we propose:

1) To establish new treatment slots for a methadone treatment and drug free treatment program located in the inner-city St. Louis area and to implement changes in their existing treatment protocols. 2) To recruit index subjects for a longitudinal study which will (a) evaluate improvements in the programs, (b) compare the efficacy of drug free treatment vs. Methadone maintenance, a culturally-specific program vs. A racially generic program, and aftercare vs. No aftercare. The outcomes assessed will include: relapse to drug use, needle sharing and high risk sexual behaviors, program retention rate, employment, criminal activities and HIV serpositivity rates. 3) To identify individual characteristics which predict changes in outcomes among individuals regardless of treatment program. Specifically, through the use of standardized interviews, we will evaluate family history, and pre-admission and follow-up characteristics such as past and current psychiatric symptoms, lifetime abuse of and dependence on drugs and alcohol, high risk sexual behaviors, knowledge of HIV transmission, and needle sharing behavior. 4) To develop a community street outreach program to reduce high risk behaviors among high risk substance abusers not in treatment and their sexual partners. We will: (a) map areas of our city and county which are at high risk for illicit drug use and high risk sexual behaviors by imputation of data from the St. Louis Epidemiological Catchment Area survey; (b) collaborate with the Public Health Department to initiate a community street outreach program which will operate in the identified high risk areas to distribute vouchers for drug treatment, to provide crisis intervention for addicts who become HIV positive, and provide educational materials concerning prevention of HIV infection and drug abuse, and (c) evaluate the efficacy of this outreach program. 5) To disseminate information gathered from this study to drug treatment programs and health officials in the Metropolitan St. Louis area. 6) To further improve drug treatment services by conducting ethnographic interviews with clients concerning reasons for staying in or dropping out of their programs; and to raise awareness by having Junior High School students produce rap music about preventing drug abuse. 7) To recruit the subjects from this study for participation in other Washington University AIDS research studies and clinical trials.
 

 

Projects

National Monitoring of Adolescent Prescription Stimulants Study (N-MAPSS)

Prescription Drug Misuse, Abuse and Dependence

Club Drug Use, Abuse, and Dependence

International Supplement

STD Supplement

Women Teaching Women - (WTW)

Improving Treatment Services for Substance Abusers with Comorbid Depression (SAD)

Sister to Sister - (STS)

Nosology

Over-the-Counter Syringe Purchase in Four Communities

Analyses to Improve Reduction in Crack Use

Each One Teach One - (EOTO)

Substance Abuse and Risk for AIDS - (SARA)

St. Louis' Effort to Reduce the Spread of AIDS and IVDUs - (ERSA)

Community Based HIV Prevention Among Females at Risk in Bangalore INDIA

Deconstructing HIV Interventions Among Female Offenders

Enrolling and Retaining Female Offenders in HIV Trials

Collaborative MDMA and Other Club Drugs Study

Evaluating the Social Structure of a Local Heroin Market (NIDA-funded)

© 2004 Washington University in St. Louis