Unity in Diversity
Examination of Contextual Factors Contributing to Drug Overdose in Baltimore City
St. Petersburg, Russia
Through mixed methods, this study examines the economic, social, and cultural context of tobacco use in a sample of individuals with high rates of poverty and substance use. In addition, we will assess the impact of health warnings and tobacco messages on tobacco perceptions and behaviors.
The proposed study focuses on palliative care, end of life issues, and caregiving resiliency among a sample of people living with HIV and their caregivers.
This project is a collaboration of city agencies and the Johns Hopkins Bloomberg School of Public Health that seeks to collaboratively examine and address key city agencies' abilities to effectively provide emergency services to those in need. The goal of the task force is to develop a multi-agency/sectoral collaborative process to review Baltimore's current public emergency services and to develop a set of recommendations to improve the city's emergency preparedness. Specifically, we aim to examine current initiatives in Baltimore, health and social systems, and propose new efforts to help improve the city's emergency medical services delivery and emergency preparedness. The study seeks to identify major inefficiencies in the current system, review lessons learned from participating agencies and other cities' programs and plans, and finally, to propose potential new initiatives or expansions of current programs to improve Baltimore's emergency response capability and disaster preparedness.
The Social Geographies study is a study that examines the socio-spatial context of HIV risk and preventive behaviors among African American men who have sex with men (AA MSM) in Baltimore. This study entails cross-sectional surveys with up to n=150 AA MSM to examine differences in HIV risk, preventive behaviors, social networks, and spatial context of behavior among AA MSM. This project was funded by the National Institute of Child Health and Human Development (NICHD).
This study focuses on the implementation of the SHIELD intervention, an evidence-based HIV prevention intervention, in community settings. The SHIELD intervention, a social-network peer education intervention for drug users, has been shown to reduce risky sex and drug behaviors. This intervention is currently being implemented in health departments and community-based organizations (CBOs) across the U.S. The purpose of this study is to (1) examine organization, provider/staff, and intervention factors associated with implementation of the intervention; (2) identify facilitators and barriers of implementation; and (3) conduct an analysis of the agency and client costs of implementation. Telephone interviews will be conducted with staff from agencies that have attended the CDC training on SHIELD. This project was funded by the National Institute of Mental Health (NIMH).
The highest rates of HIV infection in the United States are among African American men who have sex with men (AA MSM). Alcohol use can increase the risk of HIV infection by promoting risky sexual behaviors. However, the relationship between alcohol use and risky sexual behaviors among MSM has not been uniformly supported by previous studies. This study will involve conducting qualitative in-depth interviews with 40 AA MSM recruited from Baltimore, MD to explore the social factors associated with high risk sex behaviors in the context of alcohol use. Results of the study will provide preliminary data to develop novel, culturally-appropriate alcohol interventions which can address social and contextual factors of risky sexual behavior among AA MSM under the influence of alcohol in the United States. This project was funded by the National Institute on Alcohol Abuse and Alcoholism (NIAAA).
The purpose of this study is to assess the feasibility of using pharmacies as public health venues to provide HIV-related services to injection drug users (IDUs) in Xichang, China, and other settings in preparation for a large-scale, multi-site randomized community controlled intervention trial (RCCI-Trial). The 5 settings include Xichang, China; Vietnam; St Petersburg, Russia; Boston, MA; and Providence, RI. The specific aims for this project are (1) to assess current pharmacy services and how these services can be expanded to include HIV-related services for IDUs who purchase syringes in pharmacies; (2) to assess barriers to IDU and pharmacy staff participation in an HIV prevention and access to care interventions targeted to IDU syringe customers, including pharmacists’ attitudes and possible interference from law enforcement and policy makers; and (3) to identify potential local (subareas) sites for a randomized community controlled trial. This project was funded by the National Institute on Drug Abuse (NIDA).
The SNAP study is a randomized controlled trial of an experimental behavioral intervention that trains African American men who have sex with men (AA MSM) to (1) recruit their social network members for HIV voluntary counseling and testing (VCT) and (2) conduct peer health education to promote HIV risk reduction among their social network members. This project was funded by the National Institute on Drug Abuse (NIDA).
The Prevention & Testing study is a randomized controlled trial of an HIV prevention and medical care intervention to train HIV seropositive drug users to be peer health educators who (1) recruit their high risk social network members for voluntary HIV counseling and testing (VCT), (2) promote risk reduction among social network members, and (3) promote engagement in HIV care by encouraging HIV seropositive network members to schedule and keep HIV primary care appointments. This project was funded by the National Institute on Drug Abuse (NIDA).
The study will pilot test the feasibility/acceptability of introducing drug abuse screening and standard of care (SOC) into routine Baltimore City Emergency Medical Service (EMS) practices, coupled with a corresponding interagency-coordinated active referral to drug (opiates/opioids) abuse treatment. Eligible EMS patients will be referred to the study site, and those who enroll in the study will be randomized to Brief Intervention (BI), or BI with added incentives, to improve treatment entry; this will be compared with SOC/usual care practices. Additionally, the study will be testing the feasibility of an EMS approach to HIV seek, test, treat of active drug-using PLHAs. Patients with confirmed HIV+ status will be offered preferential enrollment in a medical clinic-based buprenorphine program for integrated HIV and drug abuse treatment. This project was funded by the National Institute on Drug Abuse (NIDA).
The major goal of the Workshop study is to implement and evaluate an intervention to reduce drug and sexual HIV risk behaviors and depressive symptoms among inner city heroin and crack users. In this project participants are taught strategies to cope with their everyday, chronic stress which may be the trigger for engaging in HIV risk behaviors. Another element of this study is to examine the relationships among neighborhood characteristics, social network factors, depressive symptoms, other individual-level factors, and HIV risk behaviors. Workshop was funded by the National Institute on Drug Abuse (NIDA).
The STEP Project was a randomized controlled trial meant to assess the effectiveness of a peer-based, personal risk network-focused HIV prevention intervention. The main objectives of the intervention were (1) to train injection drug users (IDUs) to reduce injection and sex related risk behaviors, (2) to train IDUs to be peer health educators that conduct outreach to individuals in their personal social networks, and (3) reduce HIV risk behaviors among the participants' risk network members. The STEP project was funded by the National Institute on Drug Abuse (NIDA).
The CHAT Project was a randomized controlled trial of a behavioral intervention designed to train heterosexual women to be peer mentors. The program taught women communication skills that allow them to talk about safer sex and HIV/STD prevention with people in their community, including friends, family and sex partners. We are currently in the data analysis phase of the study. This project was funded by the National Institute of Mental Health (NIMH).
The SHIELD (Self Help in Eliminating Life-Threatening Diseases) Project was funded by the National Institute on Drug Abuse (NIDA). The goal of the intervention was to reduce HIV infection by training individuals in communication and HIV prevention skills to promote risk reduction among their peers and the broader community. SHIELD utilized peers to diffuse information and skills through social networks. Rigorous scientific evaluation demonstrated effectiveness in reducing injection risk behaviors and increasing condom use with casual partners. This project was funded by the National Institute on Drug Abuse (NIDA).
Rigorous scientific evaluation demonstrated the effectiveness of the SHIELD intervention in reducing injection risk behaviors and increasing condom use with casual partners. The SHIELD Replication project involved packaging the SHIELD intervention to be utilized by CBOs. The SHIELD Intervention package consists of the SHIELD curriculum, policies, procedures, and an evaluation module. For more information, please contact Melissa Davey-Rothwell (firstname.lastname@example.org) or Karin Tobin (email@example.com). SHIELD Replication was funded by the Centers for Disease Control and Prevention (CDC).
The Unity in Diversity (UND) project was a culturally-tailored, theoretically-based HIV prevention intervention targeting black men who have sex with men who may identify as straight, gay or bisexual. The intervention utilized peer outreach and social network approaches. Individuals were trained in risk reduction and communication skills so that they could conduct HIV prevention outreach. A Community Advisory Board served on this project to provide the study team with feedback and suggestions for refining the peer-based HIV prevention intervention, to advise on recruitment and retention strategies, and to ensure cultural relevance of the program. We are currently in the data analysis phase of the study. UND was funded by the The Centers for Disease Control and Prevention (CDC).
This research project aimed to longitudinally examine influences of support networks and informal caregivers on HIV medical adherence among former or current drug users living with HIV/AIDS. The findings will be used to develop and pilot a behavioral intervention to improve HIV medical adherence. Beacon was funded by the National Institute on Drug Abuse (NIDA).
The ANCHOR (Assisting Networks to Create Healthy Opportunities and Resources) Project included a prevention intervention that targeted social networks of peers who are at risk for HIV and other sexually transmitted diseases (STDs). Participants were recruited from the Baltimore City Health Department STD clinic. The eligible participants were provided a six-session behavioral intervention that focused on skill building and network support for HIV and other STD prevention. Participants were taught methods of encouraging and supporting their friends and peers to engage in HIV and other STD prevention behaviors. This study built on our previous network intervention with injection drug users (IDUs). There was evidence documented that individuals who participated in that study were significantly more likely to reduce HIV-related behaviors. The ANCHOR Project was funded by the National Institute on Child and Human Development (NICHD).
The goal of this study was to collect information about fatal and non-fatal drug overdose experiences in Baltimore City to inform the development of social-behavioral and pharmacological preventive interventions. The specific aims of the project were to (1) assess the frequency of drug overdose-related deaths in Baltimore City; (2) examine drug users' and emergency medical technicians' (EMTs) overdose experiences and attitudes; and (3) collect data on drug users' experiences with and attitudes toward drug overdose and related medical help seeking behaviors. this study was funded by the National Institute on Drug Abuse (NIDA) and the Open Society Institute.
The INSPIRE (Intervention for Seropositive IDUs Research and Intervention) Project was a multi-site study that took place in Miami, San Francisco, New York, and Baltimore. It was designed to increase the access and use of primary medical care among injection drug users who are living with HIV. Participants were trained to become peer mentors in the community. The overall purpose of INSPIRE was to assess the usefulness of an intervention for people with HIV/AIDS who inject drugs. The primary goals of the intervention were (1) to prevent HIV transmission due to high risk sexual and drug injection behaviors; (2) to increase access to, use of, and maintenance in primary health care; and (3) to increase access to, use of, and adherence to HIV treatments among seropositive injection drug users. The intervention was 10 sessions long, 8 of which were groups and 2 of which were individual counseling. The INSPIRE study was funded by the Centers for Disease Control and Prevention (CDC).
The SHORE (Supporters and Helpers Organizing Resources and Education) study was a needs assessment study focused on examining the psychosocial impacts of drug use, HIV, and other diseases on caregivers, supporters, and family members. This longitudinal study monitored the lives of 800 individuals who were at risk of acquiring and transmitting HIV and other infectious diseases. Subsequent research under the rubric of the SHORE project included interviews with the supporters of the above-mentioned cohort. The 800 individual participants who were enrolled in the study nominated supporters. Supporters were interviewed about their health and well-being, their needs for support, and their other care-giving activities. This project was funded by the National Institute on Drug Abuse (NIDA).
The SAIL (Social Affiliates and Injectors Lives) Project was a three-year study that examines the role of family members and friends in an individual's health and well being. The study assessed psychosocial functioning and informal caregiving among a subset of IDUs recruited from the ALIVE study. Data collected on HIV-infected intravenous drug users (IDUs) included depressive symptoms, social support networks, support seeking behaviors, quality of life, household, stress coping, social stigmatization, attitudes about adherence, relationship with care provider, and service utilization. IDUs and their caregivers/supporters were interviewed. Based on behavior change theories and research at the Lighthouse, prevention interventions have been developed for IDUs and other at high risk groups. In these studies, social, behavioral, and biomedical predictors of behavior change and long-term maintenance of risk reduction have been developed. This project was funded by the National Institute on Drug Abuse (NIDA).
The PATH (Peoples Attitudes Toward Testing for HIV) Project was a multi-site, cross-sectional community-based survey among people at high risk for HIV infection. The project was funded by the Centers for Disease Control and Prevention. The specific aims of the study were (1) to compare demographic, behavioral, health, lifestyle, and attitudinal characteristics among individuals at high risk for HIV infection who do and do not adequately utilize HIV testing services; (2) to determine the barriers to getting HIV testing and factors associated with perceived likelihood of future HIV testing among those who do not adequately utilize HIV testing services,; and (3) to compare preferences for different HIV testing options (e.g. traditional, rapid, or oral kits) across different categories of HIV risk, demographic, behavioral, health, and lifestyle characteristics. Recruitment for the study was from October 1999 through August 2000. There were 1,290 participants in the survey and 20% reported never being tested for HIV. This project was funded by the National Institute on Drug Abuse (NIDA).
The ARK project examined social and behavioral factors that may promote or reduce access and adherence to HIV medical care. The goals were to promote the health and well being of individuals, their supporters, and children.This project was funded by the National Institute on Drug Abuse (NIDA).
The purpose of this study is to evaluate the efficacy of a peer-based, social-network-oriented, HIV prevention intervention that targets injection drug users in Chennai, India, and their risk network members. Injection drug users who are randomized into the intervention condition learn how to conduct HIV outreach among their drug-using partners and other social network members in order to share strategies for reducing HIV and hepatitis infections. This project was funded by the National Institute on Drug Abuse (NIDA).
The goals of this study were (1) to assess drug use patterns, mobility patterns, and concomitant HIV-related risk behaviors among substance users in Lithuania and (2) to pilot a network-oriented behavioral intervention to reduce drug use and other HIV-related risk behaviors among injectors. This project was funded by the National Institute on Drug Abuse (NIDA).
The purpose of this study was to evaluate the efficacy of a peer-educator intervention focused on the drug and sexual networks versus HIV voluntary counseling and testing (VCT) on reducing the rate of HIV risk behaviors among active IDUs and members of their HIV risk network in St. Petersburg, Russia. This project was funded by the National Institute on Drug Abuse (NIDA).