EFFECTS OF A COMMUNITY OUTREACH PROGRAM IN HIV RISK BEHAVIORS AMONG INJECTION-DRUG USERS IN SAN-JUAN, PUERTO-RICO - AN ANALYSIS OF TRENDS

This report assesses the effects of a community outreach program in re ducing HIV risk behaviors among injection drug users (IDUs) in San Jua n, Puerto Rico. Participants were 1,113 IDUs, 88.3% of whom were also assessed at post-intervention. The analytic strategy consisted in mode ling pre- and post-intervention trends in risk behavior levels from su ccessive cohorts of IDUs. The trend analyses showed that secular trend s, unrelated to the direct effects of the outreach intervention, accou nted for significant portions of the reported risk reductions. Neverth eless, the post-intervention trends in the shared use of cookers and i n needle bleaching showed shifts that could not be accounted for by th e modeled secular trends. The outreach intervention appears to have ha d significant but partial effects on the behavioral risks associated t o drug injection and no effect on sexual behaviors. The strengths and weaknesses of time-trend analyses for evaluating community HIV-prevent ion programs lacking experimental designs are discussed.