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  Humans Behaving Badly

Networking Opportunities

From the start, HBS decided that one focus of its efforts had to be the ecology of illness on its doorstep: the troubled neighborhoods of inner-city Baltimore. Carl Latkin, one of HBS' founding professors, studies HIV transmission in East Baltimore. Part of his current work involves the Lighthouse, a research clinic within walking distance of his faculty office, where researchers study disease prevention, including transmission of HIV/AIDS.

Carl Latkin teaches drug users how to help others — and in turn, how to help themselves. From the start, HBS decided that one focus of its efforts had to be the ecology of illness on its doorstep: the troubled neighborhoods of inner-city Baltimore. Carl Latkin, one of HBS' founding professors, studies HIV transmission in East Baltimore. Part of his current work involves the Lighthouse, a research clinic within walking distance of his faculty office, where researchers study disease prevention, including transmission of HIV/AIDS.

One current effort studies how to use the social networks of injection-drug users to promote healthier behavior. "Drug use is a very social behavior," Latkin says. The typical user has a social sphere that includes a sexual partner, three or four family members, and perhaps five or so other people with whom the user will, in the course of a week, shoot drugs. All are at risk of HIV infection if they share infected needles or have unprotected sex. So, if you are a public health practitioner who wants to persuade them not to share needles and not to have sex without condoms, how do you proceed?

The Lighthouse is studying the use of peer advocates. Physicians, social workers, and public health professionals cannot counsel every drug addict in East Baltimore. Often they are not effective talking to people about sexual practices and the need to be tested for HIV. But, says Latkin, "if we can get people who are already established in the community to promote behavior change, it's going to be more effective."

To find the people they need to reach, researchers monitor surveillance cameras, study arrest records, and prowl streets to locate drug markets and shooting galleries. Once they have identified an area of drug activity, by a variety of methods they recruit volunteers to be interviewed. From those interviews come candidates for training as peer-education counselors.

Lighthouse staff lead interactive training sessions on how to spread the word about sanitizing needles, portioning drugs without contamination, conscientious use of condoms, and addiction-treatment options. Candidates are paid for attending the training and for recruiting other peer counselors. "People come in for the money," says Karin Tobin, an assistant scientist at the Lighthouse, "but they stay for what they get out of the training." New peer counselors receive shirts, caps, cards that identify them as Hopkins/Lighthouse-trained counselors, and fanny packs loaded with sample condoms, bleach, paraphernalia for clean division of drugs, and literature.

The program, says Latkin, also gives its peer counselors something to do with their time. "If you have someone with a history of incarceration, and bad educational training, and poor job training, what's there for him to do? You can't spend your whole life going to Narcotics Anonymous meetings and watching soap operas."

Lighthouse researchers are still studying how well their health messages diffuse through neighborhoods. But Latkin notes that the counselors themselves show significant reductions in their own risky behavior. A study he published in 2003 in Health Psychology found that participants in the peer outreach program were three times more likely to report safer drug-injection habits and four times more likely to report increased use of condoms with casual sex partners. "If you want to get somebody to be more religious, get them to go out and proselytize," he says. "If you want someone to change his own behavior, get him to advocate that change. The counselors want to maintain respect in the community. If other people see them engaging in risky behavior, that significantly reduces their credibility."

One current effort studies how to use the social networks of injection-drug users to promote healthier behavior. "Drug use is a very social behavior," Latkin says. The typical user has a social sphere that includes a sexual partner, three or four family members, and perhaps five or so other people with whom the user will, in the course of a week, shoot drugs. All are at risk of HIV infection if they share infected needles or have unprotected sex. So, if you are a public health practitioner who wants to persuade them not to share needles and not to have sex without condoms, how do you proceed?

The Lighthouse is studying the use of peer advocates. Physicians, social workers, and public health professionals cannot counsel every drug addict in East Baltimore. Often they are not effective talking to people about sexual practices and the need to be tested for HIV. But, says Latkin, "if we can get people who are already established in the community to promote behavior change, it's going to be more effective."

To find the people they need to reach, researchers monitor surveillance cameras, study arrest records, and prowl streets to locate drug markets and shooting galleries. Once they have identified an area of drug activity, by a variety of methods they recruit volunteers to be interviewed. From those interviews come candidates for training as peer-education counselors.

Lighthouse staff lead interactive training sessions on how to spread the word about sanitizing needles, portioning drugs without contamination, conscientious use of condoms, and addiction-treatment options. Candidates are paid for attending the training and for recruiting other peer counselors. "People come in for the money," says Karin Tobin, an assistant scientist at the Lighthouse, "but they stay for what they get out of the training." New peer counselors receive shirts, caps, cards that identify them as Hopkins/Lighthouse-trained counselors, and fanny packs loaded with sample condoms, bleach, paraphernalia for clean division of drugs, and literature.

The program, says Latkin, also gives its peer counselors something to do with their time. "If you have someone with a history of incarceration, and bad educational training, and poor job training, what's there for him to do? You can't spend your whole life going to Narcotics Anonymous meetings and watching soap operas."

Lighthouse researchers are still studying how well their health messages diffuse through neighborhoods. But Latkin notes that the counselors themselves show significant reductions in their own risky behavior. A study he published in 2003 in Health Psychology found that participants in the peer outreach program were three times more likely to report safer drug-injection habits and four times more likely to report increased use of condoms with casual sex partners. "If you want to get somebody to be more religious, get them to go out and proselytize," he says. "If you want someone to change his own behavior, get him to advocate that change. The counselors want to maintain respect in the community. If other people see them engaging in risky behavior, that significantly reduces their credibility."

Follow this link to "Humans Behaving Badly"
Follow this link to "Networking Opportunities"
Follow this link to "TV's Healthy Influence"
Follow this link to "Mobile Home Safety"
Return to September 2006 Table of Contents

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