Outcome Evaluation of a Partnership between a Faith Based Institution and a For Profit Methadone Clinic

Background and Purpose

Of the 37,367 diagnosed cases of AIDS in the US 18,121 (48.5%) are African American (CDC, 2007). Among African American people 28.7% of persons living with AIDS attribute transmission to injection drug use (IDU). This figure does not include the 5% of African American men who report both IDU and male-to-male sexual contact nor the number of women reporting sex with injection drug users. Clearly injection drug use is an issue that must be addressed to reduce HIV/AIDS among African American people.

Project MORRE was developed as a partnership between a Faith Based Institution and a for-Profit Methadone Clinic in response to the growing need to develop culturally relevant modes of service delivery specific to HIV/AIDS risk among opiate users. The objective of this project was to measure the effectiveness of Project MORRE in:

1) Reducing alcohol and other drugs use,

2) Increasing knowledge, attitudes, and behavioral intentions related to promoting the adoption of risk-reduction strategies (substance abuse and sex-related risk),

3) Decreasing the frequency of HIV/STD risk behaviors

Methods

A single group design, with repeated measures of program outcome indicators at baseline and 6 and 12 months post-intake examined changes over the course of program participation. A census of all MORRE clients was selected. At baseline 208 participants were entered into the study, and 146 subjects provided data at both follow-up points.

Measures: The Addiction Severity Index was to measure change in drug use. The International AIDS Questionnaire was used to measure change in substance use and sexual HIV risk attitudes and knowledge. Behavioral questions about HIV risk were used to measure change in actual risk behaviors.

Analytic/Statistical Approach: A repeated measures ANOVA was used due to the multiple follow-up points and the need to control variance between members of the sample population by comparing each member against his/herself.

Description of Participants

Participants in this study were 44.2% African American, 49% Caucasian, and 4.3% Latino, and 88% of the participants were between 18 and 54 years old. Forty-one percent of the participants injected drugs and 9.6% reported sharing needles at baseline.

Results

At the one year follow-up point 44.3% of participants reported being abstinent for at least 30 days, and statistically significant decreases in substance use were reported for all drug categories. Statistically significant increases in HIV risk knowledge and attitudes were reported on all IAQ measures. Significant decreases were reported in drug injecting and needle sharing, but sexual risks were not reduced significantly.

Conclusions and Implications

Project MORRE was effective in reducing drug use, increasing HIV risk knowledge and positive attitudes regarding prevention. The findings on risk behavior were mixed with drug use risks being reduced and sexual risk behaviors not significantly decreasing. This is a matter in need of further study. The for profit methadone clinic and faith-based institution partnership proved to the advantages of increased social support and drug use stigma reduction.