High Risk Crack Use Settings and HIV in El Salvador

Study Overview
=================
Brief Summary
-----------------
This project will first increase the accessibility and acceptability of rapid HIV testing in health clinics located in or near four low-income communities in San Salvador, El Salvador. The investigators will use crack users' social networks and small incentives, as recommended by the CDC, in collaboration with the Salvadoran Ministry of Public Health and Social Assistance (MSPAS) to encourage crack users to receive HIV testing. The second part of the intervention consists of training 8 Peer Leaders to recruit and lead a Peer Network Intervention among 400 crack users to change norms supporting HIV protective behaviors. The intervention will include monthly meetings open to crack using and non-crack using community residents to reinforce HIV risk reduction skills, and discussion of other topics related to HIV such as illicit drug use and interpersonal violence and community-wide HIV awareness events. Our hypothesis is that these two intervention features will singly, and in combination, reduce HIV risk behaviors among Salvadoran crack users.

Official Title
-----------------
High Risk Crack Use Settings and HIV in El Salvador

Conditions
-----------------
HIV, Sexually Transmitted Diseases

Intervention / Treatment
-----------------
* Behavioral: Social Network HIV Testing
* Behavioral: Peer Network Intervention


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: 18 years or older used crack cocaine in the last 2 weeks Exclusion Criteria: not giving informed consent under 18 years of age considered by research staff to be unfit or unable to give informed consent engages in continued disruptive behavior while participating in the project not using crack or cocaine in the last month

Ages Eligible for Study
-----------------
Minimum Age: 18 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
Accepts Healthy Volunteers

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Prevention
Allocation: Non-Randomized
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Social Network HIV Testing<br>Participants in this arm will be recruited through social networks and will receive an HIV test. | Behavioral: Social Network HIV Testing<br>* Crack users will be recruited for HIV testing and receive 3 coupons to recruit other crack users for HIV testing.<br>|
| Experimental: Peer Network Intervention<br>Eight (8) current or former crack users will be recruited to facilitate small networks of crack users in a three-day intervention. They will also facilitate monthly meetings open to all community members regarding HIV prevention and interpersonal violence. | Behavioral: Peer Network Intervention<br>* Peer leaders will recruit small networks of crack users and facilitate a three-day prevention intervention.<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Increased HIV testing rates among crack users |  | 24 months | 
| Decreased number of sexual risk behaviors among crack users |  | 12 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Community and organizational factors associated with successful implementation of multi-level, community-based HIV prevention intervention |  | 12 months |