Introduction
Twenty years ago, AIDS made its medical debut in the United States as a disease that primarily struck gay men. The politically organized gay community mobilized against it, stressing education and prevention through safe sex, eventually lowering their transmission rate. But the AIDS virus, known for its ability to mutate rapidly within its victims, also managed to alter the demographic profile of those it infects [1]. During the course of HIV/ AIDS epidemic, the major groups at risk for HIV in the United States have been men who have sex with men, IDUs, the sexual partners of IDUs, and hemophiliacs [2].
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City health officials report that Washington D.C. has the highest rate of AIDS infection in the country, with HIV continuing to be transmitted at an epidemic pace. One in twenty residents is thought to have HIV and one in fifty residents are to have AIDS. At the end of 2006, there were 8,368 reported cases of people living in the District with AIDS, which is a forty three percent increase from 2001 [3].
The National Institute of Drug Abuse (NIDA) initiated two national intervention programs; 1. The national AIDS Demonstration Research (NADR) program and 2. The Cooperative Agreement (CA) for HIV/AIDS Community Based Outreach/ Intervention Research Program to study the effectiveness of HIV/AIDS prevention approaches among injection drug users and their sex partners. In the mid-1980s when crack cocaine emerged, the programs quickly identified it as a major risk factor for unsafe sex, other drug use, and HIV transmission [4].