Effects of outreach intervention on risk reduction among intravenous drug users

Considerable voluntary risk reduction has occurred among IVDUs in New York City. The purpose of the AIDS Outreach Project was to improve upon the existing level of risk reduction by providing information and anonymous HIV testing to street-recruited IVDUs. Intake and follow-up interviews were conducted with 121 subjects (44% of 276 at intake), with a mean of 4.5 months between interviews. Significant risk reduction occurred in many drug and sexual risk behaviors, although not in bleach use, and more than half of the subjects continued to engage in high-risk sexual behavior. An analysis of differences in risk reduction between early and later intake groups indicated that external trends were not sufficient to account for observed risk reduction. Among subjects engaged in high-risk behavior at intake, those who injected less or were enrolled in drug abuse treatment were more likely to stop high-risk drug injecting. Subjects who (at intake) engaged in less frequent unprotected sex, or who had had sex with someone with AIDS, were more likely to stop high-risk sexual behavior. The majority of subjects at low risk at intake maintained low-risk behavior. Informational interventions appear to be most successful among those IVDUs already engaging in lower levels of risk behavior. More effective methods are needed for those whose level of risk behavior is greater. These might include peer pressure and distributing bleach (as opposed to only providing information about bleach).