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Effects of an intervention program on AIDS related risk behavior among injecting drug users in Puerto Rico.


Int Conf AIDS. 1992 Jul 19-24;8(2):C291 (abstract no. PoC 4279). Unique

OBJECTIVES: This study examines the effects of an educational program in reducing risk behaviors among injecting drug users (IDUs) in Puerto Rico. The educational component was developed as an enhancement to a community outreach project. METHODS: The experimental enhancement intervention comprised three educational sessions where detailed information on HIV risk and strategies on protective behaviors were demonstrated and practiced. A problem-solving perspective guided discussion of serostatus results. A total of 2,144 IDUs not-in-treatment were recruited to the two arm intervention program over a period of 30 months, roughly half were randomly assigned to the enhanced experimental component, and 88% were re-located and re-assessed approximately 7 months after recruitment. ANALYSES: Participants had a mean age of 32.5 years, 79.7% were male, and 61.2% had not finished high school. More than three fourths (89.5%) were injecting heroin and cocaine mixed together, 82.1% on a daily basis. Mean number of years injecting drugs was 12.9 and 46.4% were found to be HIV seropositive. Substantial risk reduction in behaviors were prospectively measured. Drug use risk behaviors were reduced by 18.3% and sex risk behaviors by 11.6%. IDUs assigned to the enhanced intervention showed no significant differences in levels of risk reduction when compared to those assigned to the standard-only intervention. Furthermore, among participants of the enhanced intervention, no outcome differences were found between IDUs who attended all sessions and those who did not complete the program as designed. CONCLUSION: The analyses show substantial reductions in risk behaviors. Nevertheless, the enhanced educational component did not generate a significant additional effect to the standard arm of the program. The chronic and intensive use of injected drugs among the IDUs studied and their high prevalence of HIV infection suggest the need to develop a more intensive, expanded and continuous care model for intervention in risk reduction among this chronic group of drug injectors. Primary health systems and drug treatment programs must be central collaborators of this type of intervention. Additional implications of the findings will also be discussed.

Acquired Immunodeficiency Syndrome/*PREVENTION & CONTROL Adult Female Health Education/*METHODS Health Planning Human HIV Seropositivity/COMPLICATIONS Male Prospective Studies Puerto Rico/EPIDEMIOLOGY *Risk-Taking Sex Behavior Substance Abuse, Intravenous/*PSYCHOLOGY ABSTRACT


Information in this article was accurate in December 30, 1992. The state of the art may have changed since the publication date. This material is designed to support, not replace, the relationship that exists between you and your doctor. Always discuss treatment options with a doctor who specializes in treating HIV.