The efficacy of network-based HIV/AIDS risk reduction programs in midsized towns in the United States

Combining current psychosocial theories with social network outreach and prevention paradigms is an effective mechanism for reducing both drug- related and sexual risks for HIV transmission in active drug users in midsized towns in the United States. Five hundred and seventy-nine individuals were recruited in two towns, one of 50,000 and one of 10,000 population. Three approaches to intervention were tested. These approaches included: (1) an intensive outreach program using indigenous outreach workers providing reinforcement of an HIV risk reduction program, and (2) a low intensity outreach program combined with a more intensive office-based HIV risk reduction program. Both conditions were compared with the National Institute on Drug Abuse (NIDA) recommended standard intervention. Each of the enhanced interventions produced a reduction in HIV-related risk taking reported by the participants. The intensive outreach combined with office intervention and the intensive office intervention without outreach reinforcement each produced significant reductions in sexual risk taking in active drug users, beyond the reductions reported for the NIDA standard program. The enhanced risk reduction programs produced differential impacts for males and females, respectively, between the two high and low intensity outreach models.