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A community sample of ninety-one HIV seronegative IDUs were randomly assigned to either a one-hour, one-on-one, intensive educational intervention or a fifteen-minute "standard" educational session. Risk behaviors for the prior six months were assessed by interview before the intervention and six months later. Self-reported injecting drug use decreased from 100% to 70% at the six-month follow-up and the proportion injecting daily dropped from 42% to 18%. The proportion who used someone else's injection equipment dropped from 65% to 34%. Nearly all IDUs who continued to inject reported using bleach to clean their equipment. There was no significant additional benefit from the intensive intervention. Variables hypothesized to mediate reduction in HIV risk behavior (personal distress, perceived personal risk, and intention to reduce risky behavior) were not associated with reduction of activities with high-risk for HIV infection. These data suggest that individualized, short-term educational interventions probably have limited impact on lowering frequency of risky behaviors.

Stated reasons for sharing needles and not intending to carry bleach for 413 injection drug users in the Stop AIDS for Everyone (SAFE) study in Baltimore, Maryland, were analyzed. Over two-thirds (69%) reported they knew individuals who had "gotten in trouble" by police for carrying needles. Of the injection drug users, 38% stated the main reason they shared needles without cleaning them first with bleach was a sense of time urgency, and 30% reported that clean needles were not available. The most common reason given by 24% of the participants for not intending to carry bleach was that they inject at home where bleach is available. Another frequently mentioned reason for not intending to carry bleach was wanting to stop using drugs. These results have implications for HIV prevention and suggest the importance of preventive interventions that emphasize drug users' planning where and when they will inject drugs. The findings also suggest that needle sharing may be in part an unintended consequence of Maryland's current drug paraphernalia laws.