El estudio consistió en administrar 7 ciclos de encuestas seccionales a usuarios de crack reclutados por medio de la metodología conocida como muestreo por medio del participante o “respondent driven sampling”. Se utilizó un diseño de series de tiempo interrumpido para evaluar el efecto de la intervención. La intervención consiste de 3 componentes, los cuales se implementaron de forma secuencial: 1) pruebas rápidas de VIH en comunidades 2) promoción de la prueba de VIH por medio de la red social 3) talleres impartidos a grupos pequeños de usuarios de crack que se conocen entre sí. La investigación consistió en evaluar el efecto de una intervención comunitaria con el objetivo de reducir el riesgo de VIH en usuarios de crack residentes de comunidades de bajo ingreso en San Salvador, El Salvador. In spite of the high level of intervention reach and that self-reported exposure to intervention components was associated with lower sexual risk, reductions in sexual risk over time were not observed in the full sample, indicating that the penetration of HIV prevention components was not sufficient to produce population level change. Being referred by another crack user through the Social Network HIV intervention was also associated with reductions in total numbers of condomless sex (p<.05) The cumulative effect of being exposed to more than one intervention component was associated with reductions in total number of times individuals had condomless sex (p<.05).
Getting an HIV test at the community site was associated with reductions in total times each individual had sex without a condom (p<.05) compared to those who had been exposed to no intervention components. Results revealed a significant increase in exposure to the intervention over time with 50% of the participants reporting exposure to one or more of the three components. The intervention was evaluated with an interrupted time series design in which we used respondent-driven sampling to conduct 7 cross-sectional surveys with crack users along a 3–4 month period for each assessment (total n=1597). The intervention consisted of three components introduced sequentially: 1) rapid HIV testing in community settings 2) a Social Network HIV testing intervention and 3) Small Group interventions with crack users who were members of the same social network. This article examines the effects of a multi-level, community-based HIV prevention intervention for crack users residing in low-income neighborhoods in San Salvador, El Salvador conducted between August 2011 and June 2016.
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