INCREASING THE USE OF BLEACH AND CONDOMS AMONG INJECTING DRUG-USERS IN DENVER - OUTCOMES OF A TARGETED, COMMUNITY-LEVEL HIV PREVENTION PROGRAM

Objective: To evaluate the impact of an HIV risk reduction program amo ng injecting drug users (IDU) in Denver, Colorado. Design: A targeted, community-level intervention study with multiple, time-phased, cross- sectional measurements assessing HIV high-risk behaviors among IDU in intervention and comparison sites. Setting: Neighborhoods with high ID U prevalence in Denver, Colorado (intervention site) and Long Beach, C alifornia (non-intervention comparison site). Participants: Street-rec ruited IDU who had injected drugs in the previous 30 days and shared i njection equipment in the previous 60 days to evaluate the use of blea ch to clean injection equipment; or had sexual intercourse in the prev ious 30 days, to evaluate condom use. Intervention: A prevention progr am in which peer volunteers were recruited and trained to distribute a nd discuss intervention kits that included condoms, bleach bottles and role model stories. Main outcome measures: Multiple cross-sectional s urveys were conducted in the intervention and comparison sites to asse ss the impact of the intervention on the consistent use of bleach befo re sharing injection equipment and the consistent use of condoms for v aginal intercourse with steady and occasional partners. Results: Betwe en February 1998 and December 1993, 1997 IDU were interviewed, 890 at the intervention site and 1107 at the comparison site. In contrast to the comparison site, subjects from the intervention site reported sign ificant increases in consistent use of bleach [odds ratio (OR), 2.6; 9 5% confidence interval (CI), 1.3-5.1; P < 0.001], and consistent use o f condoms with occasional partners (OR, 13.6, 95% CI, 3.2-58.0; P < 0. 001). Conclusion: This targeted, peer-based intervention was associate d with significant HIV risk reduction among IDU in Denver and may be u seful in other communities at risk for HIV infection.