Assessing substance abuse treatment needs among the homeless: a telephone-based interactive voice response system.

OBJECTIVES: We report on a pilot project that used a telephone-based interactive voice response system accessed by cellular phones at diverse sites, to interview homeless persons on their need for alcohol and other drug treatment. METHODS: Using this technique we surveyed 207 homeless adults at eight shelters in Cleveland, Ohio. RESULTS: The cellular approach was comparable to human-administered interviews in reliability and validity and yielded higher self-reported levels of drug use. CONCLUSIONS: Cellular telephones and interactive voice response interviewing systems can be useful tools in assessing for the health-service needs of difficult-to-reach populations.

The impact of providing incentives for attendance at AIDS prevention sessions.

The research literature on AIDS prevention efforts contains many reports on the impact of intervention sessions. Little information is available, however, on the success of various strategies to recruit clients to attend these sessions. An assessment of the comparative impact of money and other types of incentives on group attendance in two AIDS risk reduction projects, in the Harlem area of New York City and in Cleveland, OH, was undertaken. In both projects, injecting drug users and the sex partners of injecting drug users were recruited to participate in group sessions that focused on the reduction of AIDS risk behaviors. Data on group attendance were analyzed for 838 people in the New York project and 1,168 in the Ohio project. After the projects were underway, attendance incentives at both were changed from money to food coupons or gift certificates. Results indicated that a nonmonetary incentive was associated with a significant decline in group attendance. Concerns regarding paying monetary incentives to injecting drug users are discussed.

Effects of an intervention program on AIDS-related drug and needle behavior among intravenous drug users.

BACKGROUND: Behaviors which entail high risk for human immunodeficiency virus (HIV) infection among intravenous drug users can be significantly reduced through educational intervention. METHODS: The educational intervention was conducted by a health educator in a one-on-one format and provided information about acquired immunodeficiency syndrome (AIDS) and strategies for reducing the risk of infection. Risk was assessed prior to the intervention and was compared to a follow-up assessment obtained approximately three months later (n = 322). RESULTS: The percentage who reported using drugs intravenously decreased from 92.2 to 70.5, and the percentage who reported sharing syringes dropped from 67.4 to 24.3. Reductions of these and other high-risk behaviors were detected across various demographic subgroups, and analyses show that the impact of the intervention endured for several months. CONCLUSIONS: The findings suggest that intravenous drug users conform to a model of rational choice when confronted with accurate information about the devastating consequences of HIV infection.

Knowledge about AIDS among intravenous drug users: an evaluation of an education program.

Increasing intravenous drug users' (IVDUs) knowledge about the etiology and symptoms of the human immunodeficiency virus is a first step in controlling the spread of the virus to the general population. A comparison of pretest and posttest measures of knowledge of acquired immune deficiency syndrome among IVDUs participating in an AIDS education program reveals significant increases in knowledge after a basic one-hour education session. Additional analyses indicate that IVDUs are more ignorant of certain aspects of AIDS than others, and frequently less amenable to education efforts related to these aspects. Finally, the analyses show that the knowledge among IVDUs about AIDS is independent of the IVDU's demographic characteristics and risk-profile.