DRUG-USERS VERSUS OUTREACH WORKERS IN COMBATING AIDS - PRELIMINARY-RESULTS OF A PEER-DRIVEN INTERVENTION

AIDS prevention efforts for injection drug users (IDUs) since 1988 in over 60 inner-city areas within the United States have been based on a ''provider-client'' model called ''street-based outreach.'' We docume nt the research showing that these traditional outreach projects opera te under conditions that cause hierarchy and supervision to break down easily, The result is an array of organizational problems that push o utreach projects toward inertia, and invite high levels of mal- and no nperformance by outreach workers (OWs) as rational adaptations to thei r work conditions. Nevertheless, research has also documented that IDU s responded very impressively to the outreach services they received. Based on IDUs' responsiveness, we outline the operational features of a ''Peer-Driven Intervention'' (PDI) that relies on an active collabor ation with IDUs in place of a ''provider-client'' model, Based on a co mparative study in eastern Connecticut, we present preliminary impact data comparing the effectiveness of a PDI with a traditional outreach intervention in terms of recruitment power, educational effectiveness of IDUs in the community, and comparative intervention costs.