Reducing HIV needle risk behaviors among injection-drug users in the Midwest: an evaluation of the efficacy of standard and enhanced interventions.

This study compares the impact of a standard and an enhanced intervention on the needle-use behaviors reported by injection-drug users (IDUs) living in a low-seroprevalence area in the Midwest. Data on the drug- and needle-use practices of 381 IDUs completing a standard (n = 232) or an enhanced (n = 149) intervention who were followed-up five to nine months after a baseline interview were analyzed using bivariate and multivariate techniques. The results indicate that IDUs who participated in the enhanced intervention reported safer needle practices than standard intervention IDUs at follow-up. In addition, less frequent injectors were much more likely to adopt safer needle-use practices than were daily drug injectors, regardless of intervention track. The results suggest that more intensive interventions have advantages over minimalist efforts--in specific contexts. This finding has important implications for the HIV needle risk-reduction efforts targeting IDUs.