FINDINGS FROM THE HORIZONTES ACQUIRED-IMMUNE-DEFICIENCY-SYNDROME EDUCATION PROJECT - THE IMPACT OF INDIGENOUS OUTREACH WORKERS AS CHANGE AGENTS FOR INJECTION-DRUG USERS

A human immunodeficiency virus (HIV)/acquired immune deficiency syndro me (AIDS) intervention using indigenous outreach workers was implement ed with Hispanic injection drug users (IDUs) and their sexual partners in three locations: Laredo, Texas; San Diego, California; and San Jua n, Puerto Rico. A total of 2,169 subjects were contacted, given health education, HIV antibody testing, and follow-up counseling. This artic le reports on the 1,616 IDUs (75%) who completed the initial and follo w-up interviews. The results indicated significant increases in health knowledge on AIDS, decreases in needle risk drug taking behaviors, so me decreases in sex risk behaviors, and more realistic perceptions of personal AIDS risk. Using multivariate analyses, gender (male) and inc reasing age (older than age 25 years) were the strongest predictors of behavior change. Surprisingly, the identification of a positive HIV s erostatus was not a significant predictor of behavior change. Although intended as a comparison study between contrasting levels of interven tion, logistical and administrative problems undermined the use of a t rue quasi-experimental design. Nonetheless, the results from this rese arch suggest that the use of indigenous outreach workers is an effecti ve means of combatting the spread of HIV in this difficult to reach po pulation. Some programmatic recommendations are provided for future ef forts of this kind, particularly in relation to role conflicts experie nced by outreach workers.