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Purpose: This study employed a static group comparison design with 106 men in residential treatment to examine the relationship of race to treatment retention. Methods: A retrospective analysis of retention, by race, including survival analysis, was undertaken. Results: Findings from the study indicated that (a) Caucasian men complete treatment more frequently than African American men, (b) Race was not predictive of time in treatment, and (c) that race was a factor in the receipt of both criminal justice coercion and case-management both of which were strong predictors of time in treatment. Conclusions: Race serves as a factor in the receipt of services related to retention. Future research should focus on further exploration how race impacts retention, and the interaction of race with coercion and the receipt of case-management. (Contains 1 table and 2 figures.)

Significant health disparities in the rates of HIV infection primarily affect African American women. Although research has demonstrated that for some individuals HIV is connected to preventable high-risk behaviors related to substance use, a further examination of how these risks are perceived by the individuals involved in these activities is warranted. This study presents the results of 11 focus groups with 89 African American women who use crack cocaine in which respondents shared their perceptions of HIV risk behaviors. The results of this study suggest that women crack cocaine users in Nashville, Tennessee, are not injecting the drug. There appeared to be high levels of perceived sexual risks associated with the use of crack cocaine by some users; however, this was not universal, as many active users have internalized HIV prevention messages. The results of this study are significant in that further understanding of the means by which individuals experience their risk behaviors will enable more effective targeting of potential interventions to reduce the spread of HIV.

The impact that substance use has on an individual with mental illness has been documented; however, little is known about the impact that this may have for a family caregiver. Data was collected in a cross sectional study using mailed questionnaires to a convenience sample of family members of persons with mental illness (n = 110). Hierarchical linear regression analysis was used to determine the impact of substance use status upon four measures of well-being within a stress-coping model. The variables within the model were able to account for a significant proportion of the variance in each of the measures: perceptions of burden, depression, anxiety and physical health status (R[superscript 2] = 0.419 to 0.202). However, substance use status was not a significant predictor in any of these equations. Symptomatology and a measure of specific social support were the most significant predictors of burden ([beta] = 0.345, p less than 0.001 and [beta] = 0.330, p less than 0.001). Perceptions of caregiver burden were found to be the most significant predictor in each of the other three analyses ([beta] = 0.515, p less than 0.000; [beta] = 0.511, p less than 0.000; [beta] = -0.571, p less than 0.000). Results of this study suggest that substance use may not be as important as the other predictors included in the model in determining the well-being of family caregivers. (Contains 2 tables.)

The threat of HIV/AIDS to African American's health has become the focus of much concern. This study investigated the potential differences between African Americans' and white college students' current and future sexual behaviors and safer sex behaviors with HIV/AIDS awareness, condom use self-efficacy, and safer sex attitudes. A convenience sample of 156 college students from three public universities was used. Of those who were sexually active, more African American than white respondents reported they used condoms frequently, and more African Americans indicated they would use condoms regularly in the future. No racial differences were found in intentions for future casual sex, condom use self-efficacy, or attitudes toward safer sex practices. Although the results suggest that for this sample African American college students appear to have internalized safer sex messages to a greater degree, both groups reported a lack of consistent safe-sex practices, which may put them at risk of HIV/AIDS.

Objective: This article provides an evaluation of a federally funded faith-based program that serves African Americans who use heroin and cocaine and are at risk for HIV/AIDS in Nashville, Tennessee. Methods: Data were collected from 163 individuals at baseline and 6- and 12-month follow-up interviews. A subset of participants (n = 51) completed all three interviews. Results: Results suggested that this culturally relevant set of interventions was successful in reducing substance use and HIV/AIDS risk behaviors. The program was able to show data that supported the efficacy of a faith-based approach emphasizing spirituality rather than directive, aggressive, authoritarian, or coercive counseling techniques. Discussion: The model is important to the continued development of culturally relevant interventions that are vital to decreasing the disproportionate rates of HIV/AIDS within the African American community. (Contains 4 tables.)

In order to address HIV infection among college students, a comprehensive measure is needed that can be used with samples from culturally diverse populations. Therefore, this paper assessed the reliability and validity of an HIV/AIDS questionnaire that measures fours dimensions of HIV/AIDS awareness--factual knowledge, prejudice, personal risk, and misconceptions about HIV transmission, and will enable cross-cultural research. The International AIDS Questionnaire-Chinese Version (IAQ-C) was developed and validated by Davis, Tang, Chan, and Noel (1999) for use with Chinese populations. In this study, the validity and reliability of the International AIDS Questionnaire-English Version (IQA-E) was assessed on a sample of English-speaking college students from the United States (N = 200) and Australia (N = 74). The results of the CFA supported the four-factor model, and the normative data show patterns similar to previous research. The total IAQ-E had a high internal consistency (Cronbach's alpha = 0.88). The Cronbach's alphas for the sub-scales were 0.87 (myths), 0.81 (attitudes), 0.66 (personal risk), and 0.40 (facts). A 2-week test-retest reliability study on a sub-sample of 32 students revealed a Pearson product-moment correlation coefficient of 0.882 (p less than 0.001). This instrument provides a valid and reliable comprehensive measure of HIV/AIDS for use with English-speaking samples. (Contains 4 tables.)

The development of cultural competency skills is important for a clinician in any cross-cultural setting where a working knowledge of the client's culture is important to the delivery of services. This paper suggests that incorporating attendance at Twelve Step recovery programs may begin to facilitate cultural competency for students, or at the very least provide exposure to the culture through a cross-cultural experience. From the perspective of cultural competency, an understanding of the culture of Twelve Step groups is important to any clinician working with clients who may be referred to, and/or are members of a Twelve Step group. This article defines cultural competency, applies this to the culture that has developed around Twelve Step groups, and provides a model of integrating Twelve Step meeting attendance into addictions coursework as a mechanism for development of cultural responsiveness with addicted clients.

Drug courts have been recognized and empirically supported as an effective means of reducing recidivism and use of substances for both juveniles and adults. The paper reports the results of an outcome evaluation of a juvenile drug court in the Upper Cumberland area of Middle Tennessee. As with previous studies, the program showed impressive outcomes for many juveniles. Improvements, however, may be possible. Adding a residential component similar to the one for adults currently operated by the Davidson County Drug Court might enhance program retention, provide housing opportunities during treatment for neglected and abused youth, and offer opportunities for more regular and intensive supervision of specific juveniles. Such programs would likely be both practical and fundable, and should be considered by courts and treatment providers. (Contains 1 table.)

This paper explores historical and recent trends in the delivery of residential adolescent substance abuse treatment, looking specifically at the impact of managed care on the service delivery system. Three historical eras are conceptualized by the authors: (1) an era prior to managed care in which services were provided on a fee for service basis by health insurance companies and lengths of stay were relatively longer; (2) an era of managed care in which services were funded through managed care organizations and lengths of stay were significantly reduced; and (3) the current era in which residential services are provided through self-pay and through other service systems. Awareness of these changes is important for all practitioners who provide services to adolescents and demonstrate the need to advocates for residential substance abuse services for all adolescents.

This article provides information on harm reduction, a recent development in substance abuse services in response to the HIV/AIDS epidemic. The author outlines abstinence and harm reduction perspectives and the stages of change model and discusses how these perspectives can be integrated in social work practice. He proposes using harm reduction strategies for individuals for whom the abstinence perspective may not be appropriate. Together, the traditional abstinence and harm reduction perspectives provide a basis for a more comprehensive continuum of care for individuals experiencing problems related to their substance use.

Significant health disparities in the rates of HIV infection primarily affect African American women. Although research has demonstrated that for some individuals HIV is connected to preventable high-risk behaviors related to substance use, a further examination of how these risks are perceived by the individuals involved in these activities is warranted. This study presents the results of 11 focus groups with 89 African American women who use crack cocaine in which respondents shared their perceptions of HIV risk behaviors. The results of this study suggest that women crack cocaine users in Nashville, Tennessee, are not injecting the drug. There appeared to be high levels of perceived sexual risks associated with the use of crack cocaine by some users; however, this was not universal, as many active users have internalized HIV prevention messages. The results of this study are significant in that further understanding of the means by which individuals experience their risk behaviors will enable more effective targeting of potential interventions to reduce the spread of HIV. KEY WORDS: crack cocaine; HIV risk; substance abuse, There is a growing awareness of disparities in the incidence of HIV/AIDS, access to care, and survival rate in the context of race in access to health care that disproportionately [...]

The threat of HIV/AIDS to African American's health has become the focus of much concern. This study investigated the potential differences between African Americans' and white college students' current and future sexual behaviors and safer sex behaviors with HIV/AIDS awareness, condom use self-efficacy, and safer sex attitudes. A convenience sample of 156 college students from three public universities was used. Of those who were sexually active, more African American than white respondents reported they used condoms frequently, and more African Americans indicated they would use condoms regularly in the future. No racial differences were found in intentions for future casual sex, condom use self-efficacy, or attitudes toward safer sex practices. Although the results suggest that for this sample African American college students appear to have internalized safer sex messages to a greater degree, both groups reported a lack of consistent safe-sex practices, which may put them at risk of HIV/AIDS. KEY WORDS: AIDS; HIV; prevention, race, In the United States, the threat of HIV/AIDS to African Americans' health is the focus of much concern. It has raised an awareness of the health disparities primarily affecting African [...]

Although representing 12 percent of the U.S. population, African Americans represent more than one-third of all cumulative AIDS cases and the majority of all new AIDS cases in the United [...]

The response of social worker educators to the Iraq war, in the three countries that initiated war with Iraq, was researched. It was found that most of them had felt that students needed to be educated about the war and had included contents of the war in their courses in different ways such as class discussions and projects.

A federally funded faith-based program is evaluated that has served African Americans using heroin and cocaine and are at risk for HIV/AIDS in Nashville, Tennessee, U.S. The results have shown that a continuum of intensive faith-based and noncoercive outcome, case management and substance abuse treatment services can be implemented and might be effective for the target population.

Notes the rise of the harm-reduction model in the provision of substance abuse services and the history and success of syringe exchange programs. Describes the Xchange Point, a nonprofit community-based AIDS services organization founded in 1996 as a street-based outreach and syringe exchange program. (Contains 15 references.) (GCP)

Despite increasing attention directed to conceptual and methodological issues surrounding spirituality and despite the centrality of 'spiritual transformation' in the recovery literature, there is little systematic evidence to support the role of spiritual change as a necessary condition for substance abuse behavior change. As an explicit conceptualization of mechanisms underlying behavior change is fundamental to effective interventions, this article: 1) briefly reviews relevant behavior change theories to identify key variables underlying change; 2) presents an integrative conceptual framework articulating linkages between program components, behavior change processes, spiritual change mechanisms and substance abuse outcomes; and 3) presents a discussion of how the mechanisms identified in our model can be seen in commonly used substance abuse interventions. Overall, we argue that spiritual transformation at an individual level takes place in a social context involving peer influence, role modeling, and social reinforcement. Keywords: Substance abuse treatment, spiritual change, behavior change models, INTRODUCTION Recently, there has been increasing attention directed to conceptual and methodological issues surrounding spirituality, religiosity, and their implications for health and well being (1). Unfortunately, systematic empirical research regarding [...]

A recent development in the provision of substance abuse services has been the rise of the harm-reduction model and non-abstinence-based services. Harm reduction is based on the suppositions that drug [...]