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2. Staying Safe: Training Injection Drug Users in Strategies to avoid HCV and HIV infectionsI.Course Description: This presentation will describe Staying Safe (Ssafe) a new strengths-based intervention to facilitate long-term prevention of HIV among young IDUs. Dr. Mateu-Gelabert will present the results of a pilot study whose participants reported large statistically significant increases in long-term risk avoidance practices and reductions in risky behaviors. 3. Staying Safe: Training Injection Drug Users in Strategies to avoid HCV and HIV infectionsII.Overall course goal: Increase knowledge about Staying Safe (Ssafe), a program to facilitate long-term prevention of HIV and HCV among young Injection Drug Users (IDUs)III. Objectives: At the end of this course, participants will be able to: 1. Describe the Staying Safe project 2. List at least 5 strategies for injection drug users to avoid stigma 3. List 2 ways to avoid problems with drug withdrawal 4. State 3 strategies that IDUs can use to inject safely 4. HIV and HCV infections among injectors continue even in places with well-developed prevention programs.We developed an innovative Staying Safe Intervention pilot study based on strategies and practices of long term IDUs who have remained HIV and HCV seronegative.If youre having problems logging into the webinar or experiencing technical difficulty prior to the start or during the session, please telephone: Citrix Online Technical Support at (800) 263-6317 5. Our ideas come from hypotheses developed in an early study:Positive deviance control-case life history: a method to develop grounded hypotheses about successful long-term avoidance of infection. BMC Public Health. 2008How can hepatitis C be prevented in the long term? Int JDrug Policy. 2007Strategies to avoid Opiate Withdrawal: Implications for HCV and HIV Risks. Int JDrug Policy 2009Symbiotic Goals and the Prevention of Blood-Borne Viruses among Injection Drug Users. Subset Use Misuse. 2010 6. 0 20% 20 40% 40 60% More than 60% 7. Ssafe overarching framework stems from: Ecosocial theory (Krieger)Symbiotic Model of Risk Reduction (Friedman)Social Action TheoryIf youre having problems logging into the webinar or experiencing technical difficulty prior to the start or during the session, please telephone: Citrix Online Technical Support at (800) 263-6317 8. Most interventions focus mainly on short term/immediate risk behaviors. Ssafe helps IDUs focus on symbiotic goals, manage risk contexts and plan long term risk prevention strategies. By changing the risk inducing upstream targets, IDUs will be less exposed to risk inducing moments. (E.g., by managing their drug intake better, IDUs can become less likely to exchange sex for drugs.) 9. Upstream Social Determinants of Risk (e.g. social isolation) Social Interaction Processes Minimize stigma Maintain social relations Maintain income & resources Individual Determinants of Risk (e.g., limited needle access)Risk ContextsRisk behaviors (Risk Behavior Targets)(Target Processes to minimize long-term risk)Unprotected sexAvoid withdrawalKnowledge Skills (planning abilityNumber of sex partnersEmbed safety in networks Storing sterile syringes Storing Condoms Manage drug intakeIndividual TargetsSharing injection equipmentBiological Outcomes HCV infection HIV infection Any STIMotivation-Self-Efficacy Resources (condoms, syringe access)Ssafe Social-Behavioral Intervention 10. Dont Know any Have used some Would like to know more Very familiar do these everyday with clients 11. Keeping from getting too dirty;Not allowing non-injectors see you inject or nod out;Avoiding track marks;Wearing long sleeves to hide track marks;Paying back any money you borrow;Avoiding abscesses (e.g. avoiding dull needles);Thinking about things other than getting money, getting drugs, and physical survival;Avoiding hanging around known injectorsAvoiding injecting cocaine/crack; 12. Balancing income and drug need.Not spending more on drugs than could be afforded. Cost of drug intake