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 among injecting drug users (IDU) in Denver, Colorado.


METHODS
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.


METHODS
Neighborhoods with high IDU prevalence in Denver, Colorado (intervention site) and Long Beach, California (non-intervention comparison site).


METHODS
Street-recruited IDU who had injected drugs in the previous 30 days and shared injection equipment in the previous 60 days to evaluate the use of bleach to clean injection equipment; or had sexual intercourse in the previous 30 days, to evaluate condom use.


METHODS
A prevention program in which peer volunteers were recruited and trained to distribute and discuss intervention kits that included condoms, bleach bottles and role model stories.


METHODS
Multiple cross-sectional surveys were conducted in the intervention and comparison sites to assess the impact of the intervention on the consistent use of bleach before sharing injection equipment and the consistent use of condoms for vaginal intercourse with steady and occasional partners.


RESULTS
Between February 1991 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 significant increases in consistent use of bleach [odds ratio (OR), 2.6; 95% confidence interval (CI), 1.3-5.1; P < 0.001], and consistent use of condoms with occasional partners (OR, 13.6; 95% CI, 3.2-58.0; P < 0.001).


CONCLUSIONS
This targeted, peer-based intervention was associated with significant HIV risk reduction among IDU in Denver and may be useful in other communities at risk for HIV infection.
Rietmeijer
C A
CA
Department of Public Health, University of Colorado Health Sciences Center, Denver, Colorado 80204-4507, USA.
Kane
M S
MS
Simons
P Z
PZ
Corby
N H
NH
Wolitski
R J
RJ
Higgins
D L
DL
Judson
F N
FN
Cohn
D L
DL
D000328:Adult; D003120:Colorado / Q000453:epidemiology; D003153:Community Health Services / Q000458:organization & administration*; D003275:Contraceptive Devices, Male / Q000706:statistics & numerical data*; D004203:Disinfection; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission; D006801:Humans; D008297:Male; D009339:Needles; D017063:Outcome Assessment, Health Care; D015995:Prevalence; D012307:Risk Factors; D012973:Sodium Hypochlorite; D015819:Substance Abuse, Intravenous / Q000150:complications* / Q000453:epidemiology
D012973:Sodium Hypochlorite