Abstract Book Vol. 2 [International Conference on AIDS (14th: 2002: Barcelona, Spain)]

498 Abstracts ThPeD7631-ThPeD7634

XIV International AIDS Conference

Results: The rehabilitation community cost for governmental budget is 176 000
Lt (44 000 $) per year. The course of one addict treatment cost 14 000 Lt (3500
$). This is small cost because:
1) Untreated drug addict spend about 47 750 Lt (11937,5 $) for drugs per year.
The average daily dose of drugs for one addict cost 130 Lt (32,5$). The money
for drugs usually are get by various crime.
2) Untreated drug addicts cost for governmental budget even more. Such are intensive therapy in hospitals (HIV/AIDS, hepatitis, sepsis, and other illnesses), the
disturbance of relatives of addicts and the impact on their working abilities, the
cost of investigation of crimes made by addicts, imprisoning, introducing of other
persons into drug use and etc. This cost can be hardly estimated exactly.
3) Most of rehabilitation community's patients get jobs successfully and return the
money spent on their treatment by taxes. The person with average salary pays
about 300 Lt (75 $) of taxes for governmental budget per month. So the successful course can be paid to governmental budget through 4 years.
Conclusions: Financial analysis of activity of Lithuania's AIDS centre's
psychological-social rehabilitation community for drug addicts revealed that longterm reahabilitation of drug addicts are cost-effective. The treated addict can pay
by taxes to governmental budget for his/her treatment through 4 years. The untreated addict cost much more than addict in rehabilitation community.
Presenting author: linas gasiliauskas, nugaletoju 3, vilnius, lithuania, 2016,
Lithuania, Tel.: [phone], Fax: [phone], E-mail: brokolis@delfi.
It
ThPeD7631I The WHO Multi-City Drug Injection Study Phase II -
combining rapid assessment with behavioural and
seroprevalence survey for intervention
development
V.B. Poznyak1, M.G. Monteiro2, D. Des Jarlais3, T. Perlis3, G.V. Stimson4,
C. Fitch4. 1 World Health Organization, Department of Mental Health and
Substance Dependence, World Health Organization, Department of Mental
Health and Substance Dependence, 20, Avenue Appia, CH- 1211 Geneva 27,
Switzerland; 2 World Health Organization, Department of Mental Health and
Substance Dependence, Geneva, Switzerland; 3The National Development and
Research Institutes, Inc., New York, United States; TheCentre for Research on
Drugs and Health Behaviour, Faculty of Medicine, Imperial College of Science,
Technology and Medicine, London, United Kingdom
Background: In response to HIV epidemic among IDUs the WHO initiated multicity study of injecting drug use that is currently being implemented in Argentina,
Belarus, China, Colombia, Iran, Kenya, Malaysia, Nigeria, Russia, Ukraine, Vietnam.
Methods: (a) Rapid Assessment and Response methodology, developed by
the Centre for Research on Drugs and Health Behaviour (UK); A retrospective
and prospective evaluation of rapid assessments on substance use; (b) Survey methodology, including behavioural and seroprevalence (HIV, HCV, HBV)
surveys, developed by the National Development and Research Institutes, Inc.
(USA).
Results: Methodology: The adapted and tested research tools are available in
several languages, including assessment formats, behavioural survey instrument
(IDU-SI), operations manual with survey sampling and recruitment procedures,
databases and procedures for data management. Rapid Assessment Reports:
Provide description of the context, nature and trends of injecting drug use and
available interventions in the 11 study sites. Seroprevalence data: Prevalence
rates of HIV, HCV and HBV among IDUs in contact with drug treatment services and without. Behavioural data: Allow quantitative analysis of the levels of
behavioural risks among IDUs. Integrated data: Linking results of rapid assessments with behavioural and seroprevalence data provides a solid basis for intervention development. Comparative analysis of the study results allows to identify
essential differences in drug injecting phenomenon and programmed preventive
interventions in "developed" and "developing" countries.
Conclusions:The study methodology can provide reliable and comprehensive information for development of preventive and treatment interventions among IDUs.
Study results give a unique global description of injecting drug use and implemented interventions in developing/transitional countries.
Presenting author: Vladimir Poznyak, World Health Organization, Department of
Mental Health and Substance Dependence, 20, Avenue Appia, CH-1211 Geneva
27, Switzerland, Tel.: [phone], Fax: [phone], E-mail: poznyakv
@who.int
ThPeD7632 Changes in HIV risk behaviors among a cohort of
drug users from Philadelphia: A 12 year follow-up
D.S. Metzger1, H.A. Navaline1, A. Davis-Vogel1, D. Mercer1, D. Fiore2,
J. Myers1, G. Fields1, C. Voytek3, P. Olgelsby1, S. Hutchins1, G. Woody1.
tUniversity of Pennsylvania, University of Pennsylvania, Center for Studies of

Addiction, 3535 Market Streeet #4001, Philadelphia, Pennsylvania 19104,
United States; 2University of Mennsylvania, Philadelphia, United States; 3John
Hopkins University, Baltimore, United States
Background: The AIDS epidemic among drug users in the United States is now
moving through its third decade. Important changes among drug users have occurred during this time. Longitudinal data can provide important insights into the
impact of the epidemic on this population and its response to it.

Methods: As the first phase of an examination of the impact of periodic counseling, testing and referral (low Threshold/Low Intensity Intervention), 203 subjects
were randomly selected from a cohort of 415 IDUs originally recruited in 1989 and
1992. Mortality, drug use patterns, risk behaviors and HIV status were examined
for this sample.
Results: Seventy subjects (34.5%) from the original cohort were determined to
have died. Of the remaining 133 subjects, 109 (82%) were contacted and reinterviewed. Thirty-seven percent reported injecting within the six months prior to
assessment (a 43% reduction from baseline) and 6% reported sharing needles
or syringes (an 86% reduction). Eleven percent (N=23) became infected with HIV
during the course of the study raising the overall prevalence rate in this sample to
29%.
Conclusions: This cohort of IDUs demonstrated long term reductions in drug
use and injection related HIV risk behaviors while participating in periodic counseling, testing, and referral. Needle-sharing declined at twice the rate of injection.
The high rate of AIDS and non-AIDS related mortality however, overshadows the
gains achieved in HIV risk reduction.
Presenting author: David Metzger, University of Pennsylvania, Center for Studies of Addiction, 3535 Market Streeet #4001, Philadelphia, Pennsylvania 19104,
United States, Tel.: [phone], Fax: [phone], E-mail: metzger@mail.
trc.upenn.edu
ThPeD7633 The role of drug abuse treatment units in HIV
prevention and services
T. D'Aunno1, H. Pollack2, B. Lamar2. 1University of Chicago, 969 e. 60th street,
chicago, illinois, 60637, United States; 2University of Michigan, Ann Arbor,
United States
Background: This paper addresses three questions about the role of the US outpatient drug abuse treatment system in the HIV/AIDS epidemic. To what extent
are treatment units providing HIV prevention services recommended by NIH Consensus Panels? To what extent are units linking affected clients to needed medical and social services? What organizational characteristics of treatment units
(e.g., staff attitudes; resources) affect their HIV prevention services and linkages
to other service providers?
Methods: To address these questions, we used data collected by the University
of Michigan' s Institute for Social Research in the National Drug Abuse Treatment
System Survey (NDATSS). NDATSS includes a nationally-representative panel
sample of several hundred treatment units in 1988, 1990, 1995 and 2000.
Results: Results from preliminary analyses show that about 75% of the treatment units in the US are engaged in HIV prevention efforts, but this number is
unchanged since 1995. Similarly, the level of medical and social services that
clients are receiving has also stayed the same since 1995. Treatment unit resources and linkages to local and state agencies are related to more prevention
efforts and service provision.
Conclusions: The results suggest ways to target efforts to support the role of
drug abuse treatment units in responding effectively to the HIV/AIDS epidemic.
Presenting author: thomas d'aunno, 969 e. 60th street, chicago, illinois, 60637,
United States, Tel.: [phone], Fax: [phone], E-mail: tdaunno
@uchicago.edu
ThPeD7634 HIV risk reduction intervention targeting women
who inject drugs: a randomized controlled trial
C.E. Sterk1, K.W. Elifson2, K.P. Theall1. 'Emory University, Emory University,
Public Health, 1518 C/lifton Road NE, Atlanta GA 30322, United States; 2Georgia
State University, Atlanta, United States
Background: An evaluation of the effectiveness of a community-based HIV risk
reduction intervention for African American women who inject drugs.
Methods: A sample of 71 HIV negative, heterosexually active women were recruited in Atlanta, Georgia using street outreach and targeted and theoretical
sampling. Data were collected between June 1998 and January 2001 at baseline, post-intervention and six-month follow-up.
Partcipants were randomly assigned to either a standard intervention condition or
one of two enhanced intervention conditions. The enhanced conditions emphasized general HIV risk reduction messages, safer sex and injection skills, and race
and gender dynamics. The enhanced motivation condition focused on motivation
to change behavior and ambivalence about change. The enhanced negotiation
condition focused on skills and conflict resolution.
Results: Significant decreases (p<.001) from baseline to post-intervention to
follow-up were found in drug use and injection frequency and sharing of syringes
and other paraphernalia. Among those still injection at follow-up, significant decreases (p<.05) were identified in number of injections with unclean syringe and
injection at high risk settings. With respect to sexual risk reduction, women reported significant (p<.05) decreases in number of casual and paying partners,
frequence of all types of sex with paying partners, and frequence of sex while

high and sex for drugs or money Women in the enhanced conditions reported
more significant risk reduction than those in the standard condtion, with the motivation being more effective in changing circumstances of drug use and sex and
the negotiation in resolving conflict.
Conclusions: Community-based HIV risk reduction interventions that address
gender and race as well as view drug users as a whole person can be effective
assisting female drug users in reducing their risk.