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CDC/HRSA Intervention for Seropositive Injection Drug Users, Research & Evaluation (INSPIRE)

About this initiative...
Background
Grantees
Journal Articles
 

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Background 

INSPIRE was a multi-site, collaborative study funded by the Centers for Disease Control and Prevention (CDC) through the Prevention Research Branch and the Epidemiology Branch, and the Health Resources and Services Administration (HRSA) through the HIV/AIDS Bureau's Special Projects of National Significance. The project began in 1999 and was funded for 5 years.

The interventions were conducted in Baltimore (Johns Hopkins University), Miami (the University of Miami), New York City (New York Academy of Medicine), and San Francisco (University of California-San Francisco).

INSPIRE was designed to develop and test an enhanced intervention for HIV-positive injection drug users (IDUs) to; 1) increase their access to and utilization of medical care; 2) increase their adherence to antiretroviral medications; 3) decrease their sexual risk behaviors, particularly with HIV-negative and partners of unknown serostatus; and 4) decrease their injection risk behaviors, particularly with HIV-negative and partners of unknown serostatus.

Nearly 1000 HIV+ IDUs were recruited (approximately 250 in each city) and randomized to one of two arms: a 10-session enhanced intervention consisting of 7 group sessions, 2 individual sessions and 1 peer volunteer activity in the community (PMI), or an 8-session video and discussion intervention (VDI). The VDI was intended to control for attention and demand. To control for demand, the first VDI session included all the intervention messages from the PMI presented in a didactic format. Risk behavior was assessed at baseline, and 3, 6, and 12 months after the intervention. Blood samples were collected at baseline, 6-month, and 12-month follow-up assessments to measure CD4 count and viral load.

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Grantees 

HRSA awarded grants under its Special Projects of National Significance program to the applicants listed below.

  • Johns Hopkins University SPH
  • New York Academy of Medicine
  • University of California
  • University of Miami

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Journal Articles 

Mizuno Y, Purcell DW, Latka MH, Metsch LR, Ding H, Gomez CA, & Knowlton AR. (2009) Is Sexual Serosorting Occurring Among HIV-Positive Injection Drug Users? Comparison Between Those with HIV-Positive Partners Only, HIV-Negative Partners Only, and Those with any Partners of Unknown Status. AIDS and Behavior, [Epub ahead of print March 24, 2009]

Latkin CA, Buchanan AS, Metsch LR, Knight K, Latka MH, Mizuno Y, Knowlton AR; and the Intervention for Seropositive Injectors Research Evaluation Team (2008) Predictors of Sharing Injection Equipment by HIV-Seropositive Injection Drug Users. Journal of Acquired Immune Deficiency Syndromes, 49 (4): 447-450.

Mizuno Y, Purcell DW, Zhang J, Knowlton AR, De Varona M, Arnsten JH, & Knight KR. (2009) Predictors of Current Housing Status Among HIV-Seropositive Injection Drug Users (IDUs): Results from a 1-Year Study. AIDS and Behavior, 13 (1): 165-172.

Purcell DW, Latka MH, Metsch LR, Latkin CA, Gómez CA, Mizuno Y, Arnsten JH, Wilkinson JD, Knight KR, Knowlton AR, Santibanez S, Tobin KE, Rose CD, Valverde EE, Gourevitch MN, Eldred L, Borkowf CB, for the INSPIRE Study Team (2007) Results from a randomized controlled trial of a peer-mentoring intervention to reduce HIV transmission and increase access to care and adherence to HIV medications among HIV-seropositive injection drug users. Journal of Acquired Immune Deficiency Syndromes, 46 (Supplement 2): S35-S47.

Mizuno Y, Purcell DW, Mackenzie S, Tobin KE, Wunch T, Arnsten JH, Metsch LR; for the INSPIRE Study Team (2007) Acceptability of A-CASI by HIV-positive IDUs in a multisite, randomized, controlled trial of behavioral intervention (INSPIRE). Journal of Acquired Immune Deficiency Syndromes, 46 (Supplement 2): S48-S54.

Mitchell SG, Edwards LV, Mackenzie S, Knowlton AR, Valverde EE, Arnsten JH, Santibanez S, Latka MH, Mizuno Y, for the INSPIRE Study Team (2007) Participants' descriptions of social support within a multisite intervention for HIV-seropositive injection drug users (INSPIRE). Journal of Acquired Immune Deficiency Syndromes, 46 (Supplement 2): S55-S63.

Arnsten JH, Li X, Mizuno Y, Knowlton AR, Gourevitch MN, Handley K, Knight KR, Metsch LR, for the INSPIRE Study Team (2007) Factors associated with antiretroviral therapy adherence and medication errors among HIV-infected injection drug users. Journal of Acquired Immune Deficiency Syndromes, 46 (Supplement 2): S64-S71.

Metsch LR, Pereyra M, Purcell DW, Latkin CA, Malow R, Gómez CA, Latka MH; for the INSPIRE Study Team. Correlates of lending needles/syringes among HIV-seropositive injection drug users. Journal of Acquired Immune Deficiency Syndromes, 46 (Supplement 2): S72-S79.

Knight KR, Shade SB, Purcell DW, Rose CD, Metsch LR, Latka MH, Latkin CA, Gómez CA, for the INSPIRE Study Team (2007) Sexual transmission risk behavior reported among behaviorally bisexual HIV-positive injection drug-using men. Journal of Acquired Immune Deficiency Syndromes, 46 (Supplement 2): S80-S87.

Latka MH, Mizuno Y, Wu Y, Tobin KE, Metsch LR, Frye V, Gómez CA, Arnsten JH, for the INSPIRE Study Team (2007) Are feelings of responsibility to limit the sexual transmission of HIV associated with safer sex among HIV-positive injection drug users? Journal of Acquired Immune Deficiency Syndromes, 46 (Supplement 2): S88-S95.

Valverde EE, Purcell DW, Waldrop-Valverde D, Malow R, Knowlton AR, Gómez CA, Farrell N, Latka MH, for the INSPIRE Study Team. Correlates of depression among HIV-positive women and men who inject drugs. Journal of Acquired Immune Deficiency Syndromes, 46 (Supplement 2): S96-S100.

Frye V, Latka MH, Wu Y, Valverde EE, Knowlton AR, Knight KR, Arnsten JH, O'Leary A, and the INSPIRE Study Team (2007) Intimate partner violence perpetration against main female partners among HIV-positive male injection drug users. Journal of Acquired Immune Deficiency Syndromes, 46 (Supplement 2): S101-S109.

Knowlton AR, Arnsten JH, Gourevitch MN, Eldred L, Wilkinson JD, Rose CD, Buchanan A, Purcell DW, and the INSPIRE Study Team (2007) Microsocial environmental influences on highly active antiretroviral therapy outcomes among active injection drug users: the role of informal caregiving and household factors. Journal of Acquired Immune Deficiency Syndromes, 46 (Supplement 2): S110-S119.

Wilkinson JD, Zhao W, Arnsten JH, Knowlton AR, Mizuno Y, Shade SB, Gourevitch MN, Santibanez S, Metsch LR; for the INSPIRE Study Team (2007) Longitudinal correlates of health care-seeking behaviors among HIV-seropositive injection drug users: how can we intervene to improve health care utilization? Journal of Acquired Immune Deficiency Syndromes, 46 (Supplement 2): S120-S126.

Coffin PO, Latka MH, Latkin C, Wu Y, Purcell DW, Metsch L, Gomez C, Gourevitch MN, and the INSPIRE Study Group (2007) Safe syringe disposal is related to safe syringe access among HIV-positive injection drug users. AIDS and Behavior, 11 (5): 652-662.

Mizuno Y, Purcell DW, Latka MH, Metsch LR, Gomez CA, & Latkin CA. (2007) Beliefs that condoms reduce sexual pleasure-gender differences in correlates among heterosexual HIV-positive injection drug users (IDUs). Journal of Urban Health, 84 (4): 523-536

Mizuno Y, Wilkinson JD, Santibanez S, Dawson Rose C, Knowlton A, Handley K, Gourevitch MN, and the Inspire Team (2006) Correlates of health care utilization among HIV-seropositive injection drug users. AIDS Care,18 (5): 417-425.

Latka MH, Metsch LR, Mizuno Y, Tobin K, Mackenzie S, Arnsten JH, & Gourevitch MN. (2006) Unprotected sex among HIV-positive injection drug-using women and their serodiscordant male partners: role of personal and partnership influences. Journal of Acquired Immune Deficiency Syndromes, 42 (2): 222-228.

Purcell DW, Mizuno Y, Metsch LR, Garfein R, Tobin K, Knight K, & Latka MH. (2006) Unprotected sexual behavior among heterosexual HIV-positive injection drug using men: associations by partner type and partner serostatus. Journal of Urban Health, 83 (4): 656-668.

Wilkinson JD, Zhao W, Santibanez S, Arnsten J, Knowlton A, Gómez CA, Metsch LR, and the INSPIRE Study Group (2006) Providers' HIV prevention discussions with HIV-seropositive injection drug users. AIDS and Behavior, 10 (6): 699-705.

Knowlton A, Arnsten J, Eldred L, Wilkinson J, Gourevitch M, Shade S, Dowling K, Purcell D, and the INSPIRE Team (2006) Individual, interpersonal, and structural correlates of effective HAART use among urban active injection drug users. Journal of Acquired Immune Deficiency Syndromes, 41 (4): 486-492.

Tuli K, Sansom S, Purcell DW, Metsch LR, Latkin CA, Gourevitch MN, Gómez CA, and the INSPIRE Team. (2005) Economic evaluation of an HIV prevention intervention for seropositive injection drug users. Journal of Public Health Management and Practice, 11 (6): 508-15.

Purcell DW, Metsch LR, Latka M, Santibanez S, Gómez CA, Eldred L, Latkin CA, and the INSPIRE Study Group. (2004) Interventions for seropositive injectors-research and evaluation: an integrated behavioral intervention with HIV-positive injection drug users to address medical care, adherence, and risk reduction. Journal of Acquired Immune Deficiency Syndromes, 37 (Supplement 2): S110-S118.

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Part F - SPNS Resources

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