Substance Use and HIV Prevention Efforts in a 50+ African American Population

Background: African-Americans, 50 and older, are an emerging group with increased risk for substance abuse and HIV infection. The Fifty Plus Prevention Program (F3P) was designed to address the lack of prevention efforts targeting this unique and under-represented population. Utilizing an evidence-based intervention (SHIELD), HIV testing, and peer advocates, the program sought to reduce substance use, increase HIV knowledge, and change attitudes toward perceived risk associated with HIV and substance use. Methods: Participants were recruited from local urban housing complexes that were predominantly occupied by the target population. They attended SHIELD, a six-session intervention, specifically adapted to be age appropriate and culturally significant. Participants were also encouraged to be tested for HIV and train as peer advocates. Outcome measures, including substance use,  HIV knowledge and perceived risk scores, were obtained from self-reported data at baseline and six-month follow-up (n=261). Results: Nearly 75% of participants attended  five or more sessions of SHIELD, 80% were tested for HIV, and fifteen peer advocates educated nearly 1200 members of the community. Of those enrolled, paired samples t-tests showed significant reductions in marijuana and illegal drug use from baseline to follow-up. Additionally, participants demonstrated a statistically significant increase in both HIV knowledge and perceived risk associated with substance use and sexual behavior. Conclusions: The F3P program had a positive impact on its participants.  In particular, participants demonstrated significant changes in their substance use, HIV knowledge, and risk perception attitudes. These changes accentuate the need for further prevention efforts targeting the unique risk factors associated with an older population.