Training Drug Treatment Clients to Conduct Peer Outreach: Preliminary Outcomes

Background: Research has shown that there is a need to reduce HIV risk behavior among drug users who used drugs in Puerto Rico (PR), and that peers are highly effective in conducting outreach to users. Methods: 81 Puerto Rican patients were recruited in 4 methadone clinics in NY. Criteria included: bilingual and previously used heroin or cocaine in PR (or had family/friends who did). Clients from 2 clinics (n=40) were randomly assigned to be trained and to conduct peer outreach (for 12 weeks); 2 clinics (n=41) were comparisons. Data were collected at baseline (T1), after outreach ended (T2), and 6 months later (T3). Results: Of those assigned to Outreach condition, 26 (65%) completed training and conducted outreach. Analyses compared them with trends for: those who did not complete the outreach program, and the comparisons. At T2- 100% of those who completed training were still in MMTP (compared to 80% and 89% of the two other groups), and were more likely to report talking with others about HIV (e.g., 48% talked with drug users vs 30% and 31%); they were also more likely to have engaged in vocational activities (16% vs 0% and 6%). At T3, these differences were not sustained. Qualitative interviews with peers indicated that while the intervention was beneficial, participants became discouraged after the project ended. Conclusions: Training MMTP clients as outreach workers is a promising approach to enhancing their vocational progress. However, methods to provide on-going support, within the clinic setting, are needed to sustain gains made.