Although some AIDS risk reduction has been reported among intravenous drug users (IVDUs) and their sexual partners (SPs), high levels of drug and sex-related risk behaviors continue. Building on previous research, the proposed field study will test the efficacy of a refined intervention designed to reduce AIDS risk behaviors in East Harlem (a community at high risk for HIV). After recruitment by street outreach, IVDUs and their SPs will be randomly assigned to participate in a Standard or Enhanced intervention. The Standard intervention will consist of (a) one AIDS education session and (b) the opportunity to participate in the project's referral service. The Enhanced intervention is based on a social learning skills training model and uses methods of popular education. The Enhanced intervention consists of (a) eight sessions focusing on developing specific skills related to AIDS risk reduction and general health improvement and (b) a required assessment by the project's referral service. In addition, subjects who have completed their second follow-up interview in a current risk reduction study will be eligible to work on the proposed study as peer facilitators and assist in the Project's AIDS reduction efforts. Both quantitative and qualitative implementation and process data will be collected during all phases of the intervention, and outcome data (focusing on AIDS risk behaviors) will be assessed through the use of baseline and 6-month follow-up interviews. Several substudies will be undertaken using selected portions of this sample. These will be designed to test the efficacy of single-sex groups, couples groups, and various incentives for group participation. Six-month and one-year follow-up interviews will be completed with subjects currently participating in the last phase of a research project underway in the community, permitting an assessment of the levels and determinants of risk reduction and its maintenance.
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