The Risk Avoidance Partnership: Training Active Drug Users as Peer Health Advocates.

Efforts have expanded to create AIDS prevention programs for drug users that consider the social context and interpersonal relationships within which risky practices take place. The Risk Avoidance Partnership (RAP) project is designed to train active drug users as "Peer/Public Health Advocates" (PHAs) to bring a structured, peer-led intervention into the sites where they and their drug-using social networks use illicit drugs. The RAP Peer Health Advocacy training curriculum and peer-led intervention promote harm reduction among drug users and support drug-user organization to reduce infectious disease and other harm in the context of injection drug use, crack cocaine use, and sexual activity. Initial findings suggest that RAP PHAs perceive a significant positive role change in themselves while conducting health advocacy work, and willingly and successfully carry the peer-led intervention into locations of high-risk drug activity to deliver it to their peers even in the absence of project staff support.