AFTERCARE TO REDUCE RELAPSE AND RISK OF HIV INFECTION

Friends Research Institute, Inc., Baltimore MD

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Abstract

DESCRIPTION: (Applicant's Abstract) The risk of post-treatment relapse to drug use and-associated illicit behaviors has been widely reported. Relapse to injection drug and crack use carries with it the threat of HIV infection. To counter the risk of relapse and the spread of disease, a six month community-based aftercare program will be developed and tested. That program will be targeted to criminal justice clients graduating from drug abuse treatment programs to which they have been assigned by the Baltimore Drug Treatment Court. The aftercare program will be housed in the communities to which treatment clients are returning. Communities will be formed by joining contiguous census tracts consistent with neighborhood characteristics. Each aftercare unit will be staffed by a supervisory case manager and two case aides, and will provide: (a) supportive counseling (b) linkages to health and social service agencies, (c) linkages to church and other community organizations, (d) work with selected family and peer groups (e) crisis intervention counseling, (f) affiliation with NA/AA and other community self-help organizations, (g) assistance with job finding and preparedness, and (h) mutual support meetings for clients. Study will be made of the capacity of the aftercare program to maintain and increase the gains from primary drug abuse treatment. Communities in Baltimore have been rated for social pathology using social indicator data. The five communities showing greatest pathology have been systematically assigned to three aftercare and two no-aftercare conditions. Clients resident in the five communities will be assessed with regard to HIV risk behaviors, drug use, criminal activity, productive behaviors, involvement in community activities, and psychological functioning at time of completion of drug abuse treatment (baseline assessment) and at 6, 12 and 18 months thereafter, that is, at the conclusion of aftercare and 6 and 12 months after receiving aftercare services. With regard to process measures, data will also be collected regarding the nature and frequency of aftercare services delivered, and that data will be related to client outcomes.