title: HIV/AIDS-related behavior change among injecting drug users in different national settings.
abstract: OBJECTIVE
  To identify factors associated with effective AIDS behavior change among injecting drug users (IDU) in different national settings.
  
  
  METHODS
  Cross-sectional surveys of IDU, with determination of HIV status. Trends in city HIV seroprevalence among IDU also used to validate effectiveness of behavior change.
  
  
  METHODS
  Subjects recruited from drug-use treatment programs and outreach efforts in Bangkok, Thailand (n = 601), Glasgow, Scotland (n = 919), New York City, USA (n = 2539), and Rio de Janeiro, Brazil (n = 466).
  
  
  RESULTS
  Evidence for the effectiveness of self-reported risk reduction was available for all cities. Univariate followed by multiple logistic regression analyses were used to identify factors associated with self-reported AIDS behavior change. Separate analyses were conducted for each city. Talking about AIDS with drug-using friends was significantly associated with behavior change in all four cities. Talking with sex partners about AIDS, educational level, knowing that someone can be HIV-infected and still look healthy, and having been tested previously for HIV were each significantly associated with behavior change in three of the four cities.
  
  
  CONCLUSIONS
  Despite the substantial differences in these national settings, there were common factors associated with effective risk reduction. In particular, risk reduction appears to occur through social processes rather than through individual attitude change. HIV prevention programs need to explicitly incorporate social processes into their work.
authors.affiliation: Chemical Dependency Institute, Beth Israel Medical Center, New York, New York, USA.
authors.forename: D C
authors.initials: DC
authors.lastname: Des Jarlais
authors.forename: S R
authors.initials: SR
authors.lastname: Friedman
authors.forename: P
authors.initials: P
authors.lastname: Friedmann
authors.forename: J
authors.initials: J
authors.lastname: Wenston
authors.forename: J L
authors.initials: JL
authors.lastname: Sotheran
authors.forename: K
authors.initials: K
authors.lastname: Choopanya
authors.forename: S
authors.initials: S
authors.lastname: Vanichseni
authors.forename: S
authors.initials: S
authors.lastname: Raktham
authors.forename: D
authors.initials: D
authors.lastname: Goldberg
authors.forename: M
authors.initials: M
authors.lastname: Frischer
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000209:etiology / Q000517:prevention & control / Q000523:psychology*; D000328:Adult; D001519:Behavior; D001938:Brazil; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000209:etiology / Q000517:prevention & control / Q000523:psychology*; D006801:Humans; D008297:Male; D009519:New York City; D012044:Regression Analysis; D012606:Scotland; D012725:Sexual Behavior; D015819:Substance Abuse, Intravenous / Q000523:psychology*; D013785:Thailand