85 EFFECT OF AUDIO COMPUTER-ASSISTED SELF- INTERVIEW ON SELF-REPORTED DRUG USE AND RISKY HEALTH BEHAVIORS. Diana H Caldwell; Friends Research Institute, Baltimore, MD Aims: <str<strong>on</strong>g>The</str<strong>on</strong>g> sensitive nature of HIV risk behaviors poses a challenge for accurate measurement in both epidemiological and clinical c<strong>on</strong>texts. This study sought to determine whether audio computer-assisted self-interviewing (ACASI) is more effective than face-to-face interview methods in eliciting reliable and valid informati<strong>on</strong> regarding stigmatized and sensitive behaviors. Methods: METHODS: Patients admitted to a drug-free outpatient substance abuse treatment program (n=177) were given a face-to-face interview about their drug use and sex risk behaviors using the TCU HIV/AIDS Risk Assessment. Within a week, the same interview was re-administered using the ACASI format. Results: <str<strong>on</strong>g>The</str<strong>on</strong>g> findings indicate potentially important interview mode differences in reported high risk behaviors. In the ACASI format, participants reported higher frequency of having sex without a c<strong>on</strong>dom while trading for drugs, m<strong>on</strong>ey, or gifts (p
89 ON-SITE HEPATITIS C TREATMENT IN METHADONE MAINTENANCE: DESCRIPTION OF A MODEL OF CARE. K Canfield 1,2 , Steven L Batki 2,1 ; 1 SUNY Upstate Medical University, Syracuse, NY, 2 Psychiatry, University of California, San Francisco, San Francisco, CA Aims: To describe a model of providing hepatitis C (HCV) medical care <strong>on</strong>-site in methad<strong>on</strong>e maintenance treatment (MMT). Methods: Opioid-dependent patients in MMT with chr<strong>on</strong>ic HCV infecti<strong>on</strong> were randomly assigned to HCV care <strong>on</strong>-site (MMT clinic) or off-site (GI clinic) as part of a NIDA-funded study. 111 patients completed randomizati<strong>on</strong> of whom 55 were assigned to <strong>on</strong>-site HCV treatment. Results: Patients assigned to <strong>on</strong>-site HCV care received interventi<strong>on</strong>s intended to facilitate engagement and adherence. Mid-level medical providers trained in HCV care management provided all medical evaluati<strong>on</strong>s and treatment interventi<strong>on</strong>s following AASLD HCV treatment recommendati<strong>on</strong>s. A hepatologist provided HCV treatment supervisi<strong>on</strong> and an addicti<strong>on</strong> psychiatrist provided psychiatric supervisi<strong>on</strong> and <strong>on</strong>going c<strong>on</strong>sultati<strong>on</strong>. All patients underwent a full medical evaluati<strong>on</strong> and psychiatric assessment with a structured clinical psychiatric interview prior to initiati<strong>on</strong> of HCV treatment. All aspects of <strong>on</strong>-site medical and psychiatric care were coordinated with the MMT clinic staff. HCV appointment reminders were provided <strong>on</strong> the day prior to and the day of HCV medical appointments utilizing the MMT check-in desk and nursing stati<strong>on</strong>. HCV medical treatment staff were readily accessible <strong>on</strong> a daily basis within the MMT setting to provide reminders and answer questi<strong>on</strong>s. On-site laboratory testing, assistance with pegylated interfer<strong>on</strong> injecti<strong>on</strong>s (if desired), and drop-in access with early morning hours were made available for the c<strong>on</strong>venience of <strong>on</strong>site patients. HCV disease and treatment educati<strong>on</strong>al sessi<strong>on</strong>s were routinely provided to <strong>on</strong>-site MMT patients as well as to MMT staff. Significantly more <strong>on</strong>-site vs. off-site subjects attended initial HCV medical visit (p ≤ 0.001) and started HCV treatment (p ≤ 0.05). C<strong>on</strong>clusi<strong>on</strong>s: A model of <strong>on</strong>-site HCV medical care provided in the MMT setting employing a variety of supportive interventi<strong>on</strong>s was associated with significantly more subjects in the On-site c<strong>on</strong>diti<strong>on</strong> completing the HCV evaluati<strong>on</strong> process and starting HCV treatment. Financial Support: NIDA R01 DA 016764 91 PATIENT AND STAFF PERSPECTIVES ON MANAGING ADDICTION AS A CHRONIC DISEASE. Robert G Carls<strong>on</strong> 1 , G S Brigham 2 , L Hammar 1 , R Falck 1 ; 1 Wright State University Bo<strong>on</strong>shoft School of Medicine, Dayt<strong>on</strong>, OH, 2 Maryhaven, Columbus, OH Aims: To describe patient and staff percepti<strong>on</strong>s of managing addicti<strong>on</strong> as a chr<strong>on</strong>ic disease through the use of a L<strong>on</strong>g-Term Recovery Management (LTRM) model that combines facilitated therapeutic alliance, c<strong>on</strong>tingency management, and the community reinforcement approach. Methods: Four focus groups were c<strong>on</strong>ducted with 10 treatment staff and 23 clients in outpatient treatment to assess their views <strong>on</strong> managing addicti<strong>on</strong> as a chr<strong>on</strong>ic disease. Participants were asked to comment <strong>on</strong> positive and negative aspects of LTRM. Participants completed an informed c<strong>on</strong>sent. Audio-recorded interviews were transcribed and coded. Results: Results: Am<strong>on</strong>g patients, 14 were white, and 9 were African-American; 12 were female. Age ranged from 21-63. Patients and staff highlighted the benefits of l<strong>on</strong>g-term care to manage addicti<strong>on</strong>. One patient said, “Your requirements to be in something that’s committed, that’s l<strong>on</strong>g-term, would be great. I’m not used to that. I’m used to this going to the treatment centers, and <strong>on</strong>ce I’m d<strong>on</strong>e, I’m d<strong>on</strong>e.” Patients emphasized the importance of being able to develop a trusting relati<strong>on</strong>ship with a counselor over time. Staff expressed c<strong>on</strong>cern about the challenges that transient patients might pose to Recovery Managers. Patients were delighted with the c<strong>on</strong>tingency management comp<strong>on</strong>ent of LTRM, but commented <strong>on</strong> the kinds of prizes that should be included. Patients also commented <strong>on</strong> the compositi<strong>on</strong> of the LTRM groups in terms of gender relati<strong>on</strong>s and relapse am<strong>on</strong>g participants. C<strong>on</strong>clusi<strong>on</strong>s: C<strong>on</strong>clusi<strong>on</strong>s: Staff and patients expressed enthusiasm for the l<strong>on</strong>gterm management of addicti<strong>on</strong> and the LTRM model. Patients suggested modificati<strong>on</strong>s that were incorporated into a pilot feasibility study of LTRM and a fully powered effectiveness trial comparing recovery trajectories am<strong>on</strong>g 200 adults randomly assigned to LTRM or Treatment as Usual. Financial Support: Wright State University, Maryhaven, Nati<strong>on</strong>al Institute <strong>on</strong> Drug Abuse, Grant No. 1 RC1 DA028467-01. <str<strong>on</strong>g>CPDD</str<strong>on</strong>g> <str<strong>on</strong>g>72nd</str<strong>on</strong>g> <str<strong>on</strong>g>Annual</str<strong>on</strong>g> <str<strong>on</strong>g>Meeting</str<strong>on</strong>g> <str<strong>on</strong>g>•</str<strong>on</strong>g> <str<strong>on</strong>g>Scottsdale</str<strong>on</strong>g>, <str<strong>on</strong>g>Ariz<strong>on</strong>a</str<strong>on</strong>g> 23 90 DISCRIMINATIVE STIMULUS EFFECTS OF THE SYNTHETIC HALLUCINOGEN N,N-DIISOPROPYLTRYPTAMINE. T Carb<strong>on</strong>aro, Michael B Gatch; Pharmacology & Neuroscience, UNT Health Science Center, Fort Worth, TX Aims: Classic hallucinogens like LSD and DMT are all known to bind to serot<strong>on</strong>in 5HT2A and 5HT2C receptors. A newer synthetic hallucinogen, N,Ndiisopropyltryptamine (DiPT), is known predominantly for its producti<strong>on</strong> of auditory hallucinati<strong>on</strong>s. Previous research using radioligand displacement binding in HEK cells showed that DiPT also binds to the 5HT2A receptor. Unlike other hallucinogens, DiPT also acts as an antag<strong>on</strong>ist at 5HT3 receptors in electrophysiological studies. Methods: Two-lever drug discriminati<strong>on</strong> was used to investigate potential mechanisms of acti<strong>on</strong> of DiPT in vivo. Adult male rats were trained to discriminate DiPT (5 mg/kg, 15 min) from saline under a FR10 schedule. Training sessi<strong>on</strong>s occurred in a double alternating fashi<strong>on</strong>. Training criteria was 85% of resp<strong>on</strong>ses <strong>on</strong> the injecti<strong>on</strong>-correct lever for both the first reinforcer and total sessi<strong>on</strong> for nine out of ten c<strong>on</strong>secutive days. <str<strong>on</strong>g>The</str<strong>on</strong>g> discriminative stimulus effects of DiPT was also tested in rats trained to discriminate LSD, DOM, DMT, MDMA, methamphetamine, and cocaine. Results: Rats were successfully trained to discriminate 5 mg/kg of DiPT from saline with a 15 minute pretreatment. An average of 60 training sessi<strong>on</strong>s (30 drug and 30 saline) were required to meet criteri<strong>on</strong>. In rats trained to discriminate various drugs, DiPT fully substituted for DOM and DMT, partially for LSD, and failed to substitute for methamphetamine, cocaine and MDMA. C<strong>on</strong>clusi<strong>on</strong>s: DiPT produces discriminable stimulus effects which are at least partially similar to those of other hallucinogens. Research <strong>on</strong> the mechanisms of DiPT may give further insight into the mechanisms of auditory versus visual hallucinogens, which may be of direct relevance to understanding why humans use hallucinogens and in the mechanism of auditory hallucinati<strong>on</strong>s in schizophrenia. Financial Support: Supported by NIH N01DA-7-8872. 92 THE INTEGRATION OF DRUG AND HIV SERVICES AT A DRUG TREATMENT CENTER IN DURBAN, SOUTH AFRICA. Tara Carney, C D Parry, P M Petersen, A Pluddemann; Alcohol and Drug Abuse Research Unit, Medical Research Council, Cape Town, South Africa Aims: Formative work c<strong>on</strong>ducted between 2005 and 2007 indicated that drug use directly increases users’ risk for c<strong>on</strong>tracting HIV through influencing their sexual and injecti<strong>on</strong> related risk behaviors. It highlighted the need to integrate HIV and drug preventi<strong>on</strong>/treatment efforts. Methods: In 2007, in collaborati<strong>on</strong> with a local NGO (an in and out-patient drug treatment center), an initiative began to roll out a number of harm reducti<strong>on</strong> strategies for drug users in Durban. In 2008, the sec<strong>on</strong>d year of this initiative was implemented. <str<strong>on</strong>g>The</str<strong>on</strong>g> interventi<strong>on</strong> activities include setting up targeted c<strong>on</strong>dom and VCT service outlets, community outreach, provisi<strong>on</strong> of voluntary counselling and testing (VCT) for drug-using populati<strong>on</strong>s and setting up referral mechanisms for drug users in need of other services. <str<strong>on</strong>g>The</str<strong>on</strong>g> MRC is resp<strong>on</strong>sible for the regular m<strong>on</strong>itoring of activities undertaken by the treatment center. Results: In the first two years of the interventi<strong>on</strong>, 1908 drug users were recruited through outreach activities. A further 495 received VCT and 125 were referred to other services. At baseline, c<strong>on</strong>dom use varied, with 40.3% using c<strong>on</strong>doms zero times in Year 1 and 51.5% using c<strong>on</strong>doms zero times in Year 2 of the interventi<strong>on</strong>. Almost all were poly-drug users in Year 1 (97.3%) with c<strong>on</strong>siderably less poly-drug use in Year 2(51.3%). Most used substances during sex (76.9% in Year 1, 61.1% in Year 2). Outreach workers assisted drug users in developing risk reducti<strong>on</strong> strategies, and reached 130 for follow-up. A high proporti<strong>on</strong> of drug users received VCT (86.5% in Year 1, 77.5% in Year 2). A higher proporti<strong>on</strong> reported using c<strong>on</strong>doms every time that they engaged in sex in Year 1 (73.1%) than in Year 2 (57.7%). C<strong>on</strong>clusi<strong>on</strong>s: <str<strong>on</strong>g>The</str<strong>on</strong>g> interventi<strong>on</strong> to date has dem<strong>on</strong>strated willingness of the NGO to broaden its service delivery activities and uptake of VCT and other services by drug-using clients. Improved integrati<strong>on</strong> of drug treatment, HIV interventi<strong>on</strong> and other services has also occurred, although challenges existed in both Year 1 and 2. Financial Support: CDC, PEPFAR
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