Case Management Reduces Drug Use and Criminality Among Drug-Involved Arrestees: An Experimental Study of an HIV Prevention Intervention

The study targeted drug users with and without histories of injection drug use both to intervene before users progress to or resume injection and to address the significant potential for sexual transmission of HIV among drug-involved noninjectors. The intervention focused on two factors believed to be associated with behavioral change: (1) social support, including perceptions of peer norms favoring risk reduction and encouragement from others to change behavior, and (2) the removal of practical barriers that might discourage behavioral change. Participants were randomly assigned to a control group, which viewed a video and received a referral guide; a referral group who viewed the videotape, received the referral guide, and received one counseling and referral session; and case management, which included the videotape, the referral guide, and an intensive 6-month case management program. Outcomes were evaluated using formal assessment instruments to measure self-reported behavior at baseline and again at 3 and 6 months. Independent data from criminal justice and drug treatment systems were analyzed to gauge the validity of the self-reports. Results revealed that case management produced important positive outcomes for drug abuse, drug treatment, and criminal recidivism despite obstacles and limitations. Although the project was not altogether successful in changing targeted behaviors, the researchers' observations and qualitative findings suggest several ways in which this intervention might be improved to achieve targeted outcomes. Findings suggest that the form of case management used can work and be improved with suitable fine tuning. Figure, tables, notes, appended discussion of case management, and 50 references