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U.S. Department of Health and Human Services

Archival Content: 1999-2005

Training Doing the Work

Abstract and summary

FROM: Greenberg J, MacGowan R, Neumann M, Long A, Cheney R, Fernando D, Sterk C, Wiebel W. Linking injection drug users to medical services: Role of street outreach referrals. Health and Social Work 1998;23(4):298-309.


Street outreach workers in HIV prevention have expanded their role to include referring injection drug users to medical services. However, little is known about whether drug users act on these referrals. The study discussed in this article examined the level of exposure to street outreach reported by injection drug users, the most common medical referrals acted on as a result of such contacts, and the predictors of acting on these referrals. Findings indicate that injection drug users with four or more contacts with street outreach workers during the preceding six months were more likely to report acting on referrals. To maximize the relevance of outreach for encouraging medical treatment, both street outreach workers and social workers in health care could benefit from cross training that focuses on strengthening the referral process.


This analysis, from 3,237 structured interviews conducted with injection drug users (IDUs) at five sites between January1994 and October 1995, examines contact with outreach workers, the most common medical referrals received and acted on as a result of this contact, and whether more frequent contact was associated with increased acting on medical referrals. Of the IDUs interviewed, 42% to 67% had talked with an outreach worker in the past 6 months and reported referrals to a number of medical services, especially HIV counseling and testing and drug treatment. IDUs with more than three contacts with outreach workers during the past 6 months were more likely to seek services. To maximize the effect of outreach on acting on referrals, training for outreach workers should address techniques for follow-up with referred IDUs; identifying and overcoming barriers to seeking medical services, especially those for minority clients; after-care referrals for clients exiting drug treatment programs; and the importance of treatment for sexually transmitted diseases in reducing risk for HIV infection.


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