COMMUNITY BASED HIV RISK REDUCTION AT US/MEXICO BORDER

The proposed study is designed to develop, implement, and assess a
culturally competent HIV prevention model for 1200 Mexican-American and
Mexican-origin injection drug users (IDUs) in the southeastern region of
the Arizona-Sonora border. The study will target the U.S.-Mexico border
communities of Douglas-Agua Prieta in Cochise County, Arizona having an
estimated cocaine/heroin-using population of 1200, and Nogales-Nogales
in Santa Cruz County, having an estimated cocaine/heroin using population
of 1500. The specific aims of the study are to: examine and identify
patterns of HIV risk in the area; assess the seroprevalence among
Mexican-origin IDUs participants; recruit 600 at-risk participants in
each site and randomly assign into one of two interventions: a. Those
who receive a standard intervention; b. those who receive the
culturally competent intervention; through statistical analysis, assess
changes in risk behaviors, and AIDS related knowledge, attitudes and
perceptions of risk between baseline and follow-up assessments; conduct
a thorough formative and process evaluation documenting the development
and implementation of the culturally competent model so others in the
U.S.-Mexico border area can replicate it if it proves to be successful
in changing core components of HIV risk. To accomplish these specific aims, the study proposes a two-staged
methodology. The first stage will utilize both quantitative and
qualitative approaches to understanding the patterns of HIV risk
engagement and possible points of prevention/intervention. In-depth
qualitative interviews and focus groups will be used to develop core
components of the proposed culturally competent intervention. The second
stage of the study will include randomization of eligible participants
to one of two community-based interventions--a standard intervention, and
a 'culturally competent' intervention designed specifically for the
Mexican-origin drug-injecting population targeted.