Establishing an HIV/AIDS intervention program for street drug users in a developing nation

The general purposes of the PROVIVA project are to establish a community HIV/AIDS surveillance and monitoring system in Rio de Janeiro and to develop, implement, and evaluate a community-based HIV/AIDS prevention and intervention program for cocaine injectors and snorters, and male transvestite sex workers, in Rio's shantytowns, prostitution districts, and other neighborhoods where rates of street drug use are high. A secondary purpose is to develop an effective field-based HIV prevention program that can be used in other communities through out Latin America and perhaps other developing nations. Conducting research in an international setting in general, and establishing a community-based seroprevalence and prevention project in a developing nation in particular, presented a myriad of procedural and logistical obstacles and complications. Within this context, this paper reviews the requirements of the National Institute on Drug Abuse cooperative agreement projects, examines the issues and problems associated with implementing this kind of research in a developing nation, and suggests appropriate solutions for dealing with these emergent circumstances and difficulties.