Strategies for primary HIV prevention that target behavioral change

In the absence of a vaccine or cure, behavioral change remains the major method to prevent transmission of the human immunodeficiency virus (HIV). Public awareness campaigns that disseminate information about the risks and routes of transmission, although important, have an insufficient influence on the behavioral changes essential to reduce the risk of HIV infection. Because of the complex interplay of cultural and psychosocial influences that guides human behavior, specific programs to decrease high-risk behavior have been developed for target populations. In this report, tested initiatives for preventing HIV infection are summarized and their success evaluated for men who have sex with men, injection drug users, and women of minority racial groups. Objective evidence of reductions in high-risk behavior in these 3 groups, which account for the majority of HIV transmissions in the United States, has critical implications for reducing the overall rate of new HIV infections.