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Comprehensive & Cost Effective Laboratory Monitoring of HIV/AIDS: an African Role Model
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Reducing HIV risks among active injection drug and crack users: the safety counts program.

Mary Jane Rotheram-Borus1, Fen Rhodes, Katherine Desmond

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The Safety Counts intervention significantly reduced risky behaviors among injection drug users (IDU) and crack users. Higher program participation correlated with greater reductions in drug use and risky sexual activity.

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Area of Science:

  • Public Health
  • Substance Abuse Research
  • HIV Prevention

Background:

  • The Centers for Disease Control and Prevention (CDC) developed the Safety Counts intervention to mitigate risks associated with drug use.
  • Reanalysis of the intervention's efficacy was prompted by the need for robust evidence in public health strategies.
  • Understanding the impact of interventions on injection drug users (IDU) and crack users is crucial for targeted public health efforts.

Purpose of the Study:

  • To reanalyze the efficacy of the Safety Counts intervention using a quasi-experimental, cross-over design.
  • To assess the impact of Safety Counts on risky sexual behaviors, drug use, and injection practices among IDU and crack users.
  • To explore the relationship between the number of Safety Counts sessions attended and the degree of behavioral risk reduction.

Main Methods:

  • A quasi-experimental, cross-over design was employed, assigning participants by neighborhood.
  • Participants included injection drug users (IDU) and crack users.
  • Follow-up assessments were conducted at 5-9 months, with 78% of participants being reassessed.

Main Results:

  • Drug users participating in the Safety Counts program reported significant reductions in risky sex, crack and hard drug use, and risky drug injection.
  • A dose-response relationship was observed: more sessions of Safety Counts attended led to greater reductions in risky behaviors.
  • The study highlights that analytical decisions can significantly influence the evaluation of intervention outcomes.

Conclusions:

  • The Safety Counts intervention demonstrates significant efficacy in reducing risky behaviors among injection drug users (IDU) and crack users.
  • The findings underscore the importance of intervention fidelity and participant engagement for maximizing public health benefits.
  • Evaluation methodologies critically impact the perceived effectiveness of public health interventions.