Adaptation and Implementation of Project Encuentro in the U.S.-Mexico Border

Summary

The proposed project is a research collaboration between the University of Texas at El Paso, The Alliance for Border Collaboratives in El Paso, Texas and Programa Companeros in Juarez City, Mexico to adapt, implement, and evaluate a multi-level community-based HIV prevention intervention (Project Encuentro). The intervention will target people who inject drugs (PWID) and consists of: 1) A social network HIV testing component, 2) a peer network psychoeducational intervention, and 3) community events. The intervention was developed in an area severely affected by violence and stigma towards people who use drugs (PWUD), El Salvador, which makes it particularly suitable for adaptation to meet the needs of PWUD living in the proposed intervention site, the U.S.-Mexico border. The proposed intervention site also has been severely affected by violence which has curtailed any prior attempts to reduce the risk of HIV acquisition among PWUD. Violence has worsened structural factors which affect HIV risk such as, increasing police persecution, stigma and reducing access to harm reduction resources. The investigators will engage in formative research to understand the context of HIV risk for PWID in the border region post violence and adapt the intervention accordingly. Findings will allow the investigators to tailor intervention components to meet the needs of PWID in the region. Subsequently, the investigators propose to test intervention effectiveness and evaluate implementation barriers and facilitators. To accomplish study aims a mixed qualitative, quantitative approach will be employed. The investigators will begin with a formative phase by conducting in-depth interviews with PWID (n = 40) living in the region to understand how the context of drug use and HIV risk changed as a result of the violence and will administer a social network survey (n = 200) to characterize the configuration of risk networks. Findings will yield the necessary information to culturally adapt the intervention to meet the needs of PWID in the region and will help the investigators focus recruitment efforts where the riskiest networks are located. After the intervention is adapted with the help of the community advisory boards and the community coalitions, the investigators will implement the intervention and will assess the effectiveness and reach via 3 waves of cross-sectional surveys administered to PWID (n=600). The investigators will assess the process of implementation by conducting ethnographic field notes of all intervention activities including community engagement and community advisory board and coalition meetings. The investigators will assess the fidelity and quality of the intervention. Lastly, the investigators will conduct key informant interviews with key stakeholders involved in the project and interviews and observations will be coded to reflect key systems factors related to successful implementation of intervention components in two intervention sites (El Paso, Texas and Ciudad Juarez, Mexico). Findings will be significant as the investigators will be conducting parallel research on the effectiveness of interventions for Latino PWUD in two very different contexts: El Salvador and the U.S-Mexico border. Findings will elucidate implementation challenges and barriers and such information can then be used to assess the effectiveness of diverse implementation strategies in organizations working to serve the needs of Latino PWUD.

Conditions

• HIV

Interventions

BEHAVIORAL

Community Events

The coalitions in collaboration with CABs and peer leaders in their respective cities convened community meetings and events and invited PWID who had participated in other intervention components, who were receiving services at the partner organizations, and members at-large to participate. Events and meetings were advertised at the partner organizations offices, by staff during delivery of harm reductions supplies at places where PWID congregated to use drugs, and through social media. Events and meetings took place at community venues including parks, neighborhood gathering spaces, and at organizations. Events covered topics about HIV, sexual health, and human rights and included health fairs.

BEHAVIORAL

Social Network HIV Testing

The social network HIV testing intervention consisted of offering rapid HIV tests to PWID using a social network referral methodology.

BEHAVIORAL

Peer Network Intervention

Two peer leaders will be selected from each city to deliver the intervention sessions. Peer leaders will recruit drug users they know who will be asked, in turn, to recruit other drug users in their networks. Peer leaders will deliver the intervention to 300 drug users (150 per border city) in cycles composed of small social networks of 5-6 PWID.

Sponsors & Collaborators

• Alliance of Border Collaboratives

  collaborator UNKNOWN

• Programa Compañeros

  collaborator UNKNOWN

• City University of New York

  lead OTHER

Principal Investigators

• Julia Lechuga, PhD · City University of New York, School of Public Health

• Rebeca Ramos, MPH · Alliance of Border Collaboratives

Study Design

Allocation

NON_RANDOMIZED

Purpose

PREVENTION

Masking

NONE

Model

SEQUENTIAL

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2017-09-07

Primary Completion

2022-08-24

Completion

2022-12-10

Countries

• United States
• Mexico

Study Locations