Psychoeducational group approach: HIV risk reduction in drug users

In two trials of a small-group AIDS prevention approach, 50 methadone maintenance patients and 98 heroin abusers in outpatient detoxification were randomly assigned to experimental or comparison conditions. Experimental condition subjects received a 6-hour, small-group intervention that aimed to improve their knowledge and attitudes about AIDS, skills in syringe sterilization and condom use, and changing high-risk needle use and sexual behaviors. Comparison subjects received a set of written materials about AIDS. At posttest and 3-month follow-ups, experimental condition subjects in both maintenance and detoxification demonstrated greater knowledge of AIDS and risk reduction practices and improved skill in demonstrating condom use. Although outpatient detoxification subjects displayed considerably more risk behaviors at study outset, the intervention's effect appeared to be more robust in methadone maintenance patients. The relative lack of impact on subjects' behaviors points out that more potent, sustained interventions need to be developed to slow the spread of HIV among injecting drug users.