needle exchange programs

Summary

Summary: Organized services for exchange of sterile needles and syringes used for injections as a potential means of reducing the transmission of infectious diseases.

Top Publications

  1. doi Evaluation of a needle social marketing strategy to control HIV among injecting drug users in China
    Zunyou Wu
    National Center for AIDS STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
    AIDS 21:S115-22. 2007
  2. ncbi Do needle syringe programs reduce HIV infection among injecting drug users: a comprehensive review of the international evidence
    Alex Wodak
    Alcohol and Drug Service, St Vincent s Hospital, Sydney, Australia
    Subst Use Misuse 41:777-813. 2006
  3. pmc Needle-exchange attendance and health care utilization promote entry into detoxification
    S A Strathdee
    Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD 21205, USA
    J Urban Health 76:448-60. 1999
  4. ncbi Decline in HIV incidence and injecting, but not in sexual risk behaviour, seen in drug users in Amsterdam: a 19-year prospective cohort study
    Catharina E A Lindenburg
    Health Service of Amsterdam, Cluster Infectious Diseases, Department of Research, 1000 CE Amsterdam, The Netherlands
    AIDS 20:1771-5. 2006
  5. doi The influence of needle exchange programs on injection risk behaviors and infection with hepatitis C virus among young injection drug users in select cities in the United States, 1994-2004
    Deborah Holtzman
    Division of Viral Hepatitis, National Center for HIV AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road, NE, Mailstop G 37, Atlanta GA 30333, USA
    Prev Med 49:68-73. 2009
  6. ncbi Hepatitis C virus antibody prevalence among injecting drug users at selected needle and syringe programs in Australia, 1995-1997. Collaboration of Australian NSPs
    M A MacDonald
    National Centre in HIV Epidemiology and Clinical Research, University of New South Wales, Sydney
    Med J Aust 172:57-61. 2000
  7. pmc Risk-taking behaviors among injecting drug users who obtain syringes from pharmacies, fixed sites, and mobile van needle exchanges
    Cari L Miller
    British Columbia Centre for Excellence in HIV AIDS, Vancouver, Canada
    J Urban Health 79:257-65. 2002
  8. ncbi Needle exchange programs and drug infection behavior
    Jeff DeSimone
    University of South Florida and National Bureau of Econimic Research, USA
    J Policy Anal Manage 24:559-77. 2005
  9. pmc HIV incidence among injection drug users in New York City, 1990 to 2002: use of serologic test algorithm to assess expansion of HIV prevention services
    Don C Des Jarlais
    Beth Israel Medical Center, 1st Ave and 16th St, New York, NY 10003, USA
    Am J Public Health 95:1439-44. 2005
  10. ncbi The impact of a police presence on access to needle exchange programs
    Evan Wood
    J Acquir Immune Defic Syndr 34:116-8. 2003

Detail Information

Publications176 found, 100 shown here

  1. doi Evaluation of a needle social marketing strategy to control HIV among injecting drug users in China
    Zunyou Wu
    National Center for AIDS STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
    AIDS 21:S115-22. 2007
    ..To evaluate the effectiveness of a needle social marketing strategy to reduce needle sharing and hepatitis C Virus (HCV)/HIV transmission among injecting drug users (IDU) in China...
  2. ncbi Do needle syringe programs reduce HIV infection among injecting drug users: a comprehensive review of the international evidence
    Alex Wodak
    Alcohol and Drug Service, St Vincent s Hospital, Sydney, Australia
    Subst Use Misuse 41:777-813. 2006
    ....
  3. pmc Needle-exchange attendance and health care utilization promote entry into detoxification
    S A Strathdee
    Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD 21205, USA
    J Urban Health 76:448-60. 1999
    ..Creating and sustaining these linkages may facilitate entry into drug abuse treatment and serve the important public health goal of increasing the number of drug users in treatment...
  4. ncbi Decline in HIV incidence and injecting, but not in sexual risk behaviour, seen in drug users in Amsterdam: a 19-year prospective cohort study
    Catharina E A Lindenburg
    Health Service of Amsterdam, Cluster Infectious Diseases, Department of Research, 1000 CE Amsterdam, The Netherlands
    AIDS 20:1771-5. 2006
    ..Initiated in 1985, the ACS enables us to study changes in trends since HAART became widespread in 1996...
  5. doi The influence of needle exchange programs on injection risk behaviors and infection with hepatitis C virus among young injection drug users in select cities in the United States, 1994-2004
    Deborah Holtzman
    Division of Viral Hepatitis, National Center for HIV AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road, NE, Mailstop G 37, Atlanta GA 30333, USA
    Prev Med 49:68-73. 2009
    Our purpose was to assess whether participation in needle exchange programs (NEPs) influenced incident hepatitis C virus (HCV) infection through effects on injection risk behaviors among young injection drug users (IDUs) in the United ..
  6. ncbi Hepatitis C virus antibody prevalence among injecting drug users at selected needle and syringe programs in Australia, 1995-1997. Collaboration of Australian NSPs
    M A MacDonald
    National Centre in HIV Epidemiology and Clinical Research, University of New South Wales, Sydney
    Med J Aust 172:57-61. 2000
    ..To describe point prevalence of HCV antibody and relevant risk behaviour among people who inject drugs and who attended selected needle and syringe programs throughout Australia in 1995, 1996 and 1997...
  7. pmc Risk-taking behaviors among injecting drug users who obtain syringes from pharmacies, fixed sites, and mobile van needle exchanges
    Cari L Miller
    British Columbia Centre for Excellence in HIV AIDS, Vancouver, Canada
    J Urban Health 79:257-65. 2002
    ..Use of distribution beyond fixed sites will improve such outreach, thereby increasing program effectiveness and further preventing the transmission of blood-borne infections...
  8. ncbi Needle exchange programs and drug infection behavior
    Jeff DeSimone
    University of South Florida and National Bureau of Econimic Research, USA
    J Policy Anal Manage 24:559-77. 2005
    ....
  9. pmc HIV incidence among injection drug users in New York City, 1990 to 2002: use of serologic test algorithm to assess expansion of HIV prevention services
    Don C Des Jarlais
    Beth Israel Medical Center, 1st Ave and 16th St, New York, NY 10003, USA
    Am J Public Health 95:1439-44. 2005
    ..Syringe exchange increased greatly during this period, from 250,000 to 3,000,000 syringes exchanged annually...
  10. ncbi The impact of a police presence on access to needle exchange programs
    Evan Wood
    J Acquir Immune Defic Syndr 34:116-8. 2003
  11. ncbi Harm reduction interventions, behaviours and associated health outcomes in France, 1996-2003
    Julien Emmanuelli
    Département Maladies Infectieuses, Institut de Veille Sanitaire, St Maurice, France
    Addiction 100:1690-700. 2005
    ..To track the effect of the French harm reduction programme targeted at intravenous drug users (IDUs) and associated health outcomes...
  12. ncbi Measuring the impact of needle exchange programs among injecting drug users through the National Behavioural Surveillance in Bangladesh
    C Jenkins
    Family Health International, IMPACT, Bangladesh, Dhaka
    AIDS Educ Prev 13:452-61. 2001
    ..Behavioral surveillance methods have the potential to measure intervention impact through comparative analysis in certain settings...
  13. ncbi Hepatitis C virus infection and needle exchange use among young injection drug users in San Francisco
    J A Hahn
    Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
    Hepatology 34:180-7. 2001
    ..We conclude that anti-HCV prevalence is lower than in previous studies of older IDUs, but 11% incidence implies high risk of HCV infection in a long injecting career. Despite access to sterile needles, borrowing of needles persisted...
  14. ncbi Safer injection facility use and syringe sharing in injection drug users
    Thomas Kerr
    British Columbia Centre for Excellence in HIV AIDS, St Paul s Hospital, 608 1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada
    Lancet 366:316-8. 2005
    ..30, 0.11-0.82, p=0.02) after adjustment for relevant sociodemographic and drug-use characteristics. These findings could help inform discussions about the merits of such facilities...
  15. ncbi Strategies to improve access to sterile syringes for injection drug users
    Josiah D Rich
    Brown University School of Medicine, Providence, Rhode Island, USA
    AIDS Read 12:527-35. 2002
    ..b>Needle exchange programs (NEPs), syringe prescription, and syringe deregulation are 3 approaches to increasing access to sterile ..
  16. ncbi Trends in HCV prevalence among injecting drug users in Glasgow and Edinburgh during the era of needle/syringe exchange
    D Goldberg
    Department of Public Health, University of Glasgow, UK
    Scand J Infect Dis 33:457-61. 2001
    ..Further investigative and preventive work is required...
  17. ncbi Syringe disposal among injection drug users in Harlem and the Bronx during the New York State Expanded Syringe Access Demonstration Program
    Charles M Cleland
    National Development and Research Institutes NDRI, New York, New York 10010, USA org
    Health Educ Behav 34:390-403. 2007
    ..More detailed information on disposal practices is needed to capture the continuum from least to most safe practices and variation within individuals...
  18. pmc Approval of syringe exchange programs in California: results from a local approach to HIV prevention
    Ricky N Bluthenthal
    Health Program and Drug Policy Research Center, RAND Corp, 1776 Main S, PO Box 2138, Santa Monica, CA 90407 2138, USA
    Am J Public Health 98:278-83. 2008
    ..We studied the effect of local approval of syringe exchange programs in California (through Assembly AB136) on program availability and performance...
  19. ncbi Reductions in hepatitis C virus and HIV infections among injecting drug users in New York City, 1990-2001
    Don C Des Jarlais
    Beth Israel Medical Center, New York, NY 10038, USA
    AIDS 19:S20-5. 2005
    ..The 1990-2001 time period included a very large expansion of syringe exchange in New York City, from 250,000 to 3,000,000 syringes exchanged annually...
  20. ncbi Lower syringe sharing and re-use after syringe legalization in Rhode Island
    Josiah D Rich
    The Miriam Hospital, 164 Summit Avenue, Providence, RI 02906, USA
    Drug Alcohol Depend 89:292-7. 2007
    ..Laws and policies that increase legal syringe availability can decrease injection related transmission of HIV and other infectious diseases...
  21. pmc Major decline of hepatitis C virus incidence rate over two decades in a cohort of drug users
    Charlotte H S B van den Berg
    Department of Human Retrovirology, Academic Medical Center, and Health Service of Amsterdam, Nieuwe Achtergracht 100, 1018 WT Amsterdam, The Netherlands
    Eur J Epidemiol 22:183-93. 2007
    ..4 times the HIV incidence, a pattern seen over the entire study period. The simultaneous decline of both HCV and HIV incidence probably results from reduced risk behavior at the population level...
  22. ncbi Pharmacists' attitudes and concerns regarding syringe sales to injection drug users in Denver, Colorado
    Beth A Lewis
    University of California at Irvine, USA
    J Am Pharm Assoc (Wash) 42:S46-51. 2002
    ..To identify factors influencing pharmacists' decisions about selling syringes to injection drug users (IDUs)...
  23. pmc Increasing syringe access and HIV prevention in California: findings from a survey of local health jurisdiction key personnel
    Thomas J Stopka
    Office of AIDS, California Department of Health Services, Sacramento, CA 95899 7426, USA
    J Urban Health 84:116-25. 2007
    ..Further research is needed to identify facilitators and barriers to adopting SB1159, to identify areas for improving technical assistance to implementers, and to assess the public health impact of the legislation...
  24. pmc Increased access to unrestricted pharmacy sales of syringes in Seattle-King County, Washington: structural and individual-level changes, 1996 versus 2003
    Ryan J Deibert
    Health Services Department, School of Public Health and Community Medicine, University of Washington, Seattle, USA
    Am J Public Health 96:1347-53. 2006
    ..Structural changes, including policy reform and pharmacy outreach, appear to increase syringe access. Interventions should address pharmacy policies and pharmacist attitudes and policies...
  25. ncbi Advocacy and coverage of needle exchange programs: results of a comparative study of harm reduction programs in Brazil, Bangladesh, Belarus, Ukraine, Russian Federation, and China
    Dave Burrows
    AIDS Projects Management Group, Sydney, Australia
    Cad Saude Publica 22:871-9. 2006
    ..Monitoring to determine regular reach (those who are in regular contact with harm reduction services) should be added to uniform data collection carried out by harm reduction programs. Advocacy is crucial to achieving high coverage...
  26. ncbi Expanding access to syringes
    Valerie Rose
    Focus 22:1-5. 2007
  27. ncbi Multiple access to sterile syringes for injection drug users: vending machines, needle exchange programs and legal pharmacy sales in Marseille, France
    J P Moatti
    INSERM Research Unit 379, Social Sciences Applied to Medical Innovation, Institut Paoli Calmettes, Marseille, France
    Eur Addict Res 7:40-5. 2001
    ..programs for injection drug users (IDUs) simultaneously include access to sterile syringes through needle exchange programs (NEPs), legal pharmacy sales and, since 1996, vending machines that mechanically exchange new syringes ..
  28. pmc Expanding harm reduction services through a wound and abscess clinic
    Lauretta E Grau
    Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, Conn 06520, USA
    Am J Public Health 92:1915-7. 2002
    ..Distribution of cards advertising the clinic was substantially less effective than word of mouth in increasing community awareness of the clinic...
  29. ncbi The impact of behavioural changes on the prevalence of human immunodeficiency virus and hepatitis C among injecting drug users
    John M Murray
    School of Mathematics, University of New South Wales, Sydney NSW 2052, Australia
    Int J Epidemiol 32:708-14. 2003
    ..In Australia in 1997, HIV prevalence among attendees at Needle Exchange Programs was 1% while HCV prevalence was 50%...
  30. pmc Changes in public order after the opening of a medically supervised safer injecting facility for illicit injection drug users
    Evan Wood
    Department of Health Care and Epidemiology, British Columbia Centre for Excellence in HIV AIDS, St Paul s Hospital, Vancouver, BC
    CMAJ 171:731-4. 2004
    ..22, 2003. Although similar facilities exist in a number of European cities and in Sydney, Australia, no standardized evaluations of their impact have been presented in the scientific literature...
  31. ncbi Do supervised injecting facilities attract higher-risk injection drug users?
    Evan Wood
    British Columbia Centre for Excellence in HIV AIDS, St Paul s Hospital, Vancouver, British Columbia, Canada
    Am J Prev Med 29:126-30. 2005
    ..We examined whether North America's first SIF was attracting IDUs who were at greatest risk of overdose and blood-borne disease infection...
  32. ncbi The effect of syringe exchange use on high-risk injection drug users: a cohort study
    R N Bluthenthal
    Drug Policy Research Center and Health Program, RAND, Santa Monica, California 90407 2138, USA
    AIDS 14:605-11. 2000
    ..To determine whether syringe exchange program use is associated with cessation of syringe sharing among high-risk injection drug users...
  33. ncbi Sterile syringe access conditions and variations in HIV risk among drug injectors in three cities
    Ricky N Bluthenthal
    Health Program and Drug Policy Research Center, RAND, Santa Monica, CA 90407 2138, USA
    Addiction 99:1136-46. 2004
    ..SEPs associated with less likelihood of syringe re-use and receptive syringe sharing? (3) Among non-SEP users, is residing in an area with pharmacy access associated with lower likelihood of syringe re-use and receptive syringe sharing?..
  34. ncbi Integrating multiple programme and policy approaches to hepatitis C prevention and care for injection drug users: a comprehensive approach
    Guthrie S Birkhead
    AIDS Institute, New York State Department of Health, Albany, NY 12237, United States
    Int J Drug Policy 18:417-25. 2007
    ..HCV/HIV co-infection is common and models of service delivery that effectively meet IDUs' needs are required. A HCV strategic plan has stressed integration...
  35. ncbi Receptive syringe sharing among injection drug users in Harlem and the Bronx during the New York State Expanded Syringe Access Demonstration Program
    Enrique R Pouget
    National Development and Research Institutes, Inc, New York, NY 10010, USA
    J Acquir Immune Defic Syndr 39:471-7. 2005
    ....
  36. doi Accessing care for injection-related infections through a medically supervised injecting facility: a qualitative study
    Will Small
    British Columbia Centre for Excellence in HIV AIDS, St Paul s Hospital, University of British Columbia, Canada
    Drug Alcohol Depend 98:159-62. 2008
    ..This study emphasizes that the facility enables contact with the healthcare system and thereby helps to facilitate the management of injection-related infections...
  37. pmc The role of needle exchange programs in HIV prevention
    D Vlahov
    Department of Epidemiology, John Hopkins School of Hygiene and Public Health, Baltimore, MD 21205, USA
    Public Health Rep 113:75-80. 1998
    ..It is estimated that in 1997 there were approximately 110 needle exchange programs (NEPs) in North America...
  38. ncbi Cost-effectiveness of syringe exchange as an HIV prevention strategy
    F N Laufer
    Division of HIV Prevention, AIDS Institute, New York State Department of Health, Albany, New York 12237, USA
    J Acquir Immune Defic Syndr 28:273-8. 2001
    ..To analyze the cost-effectiveness of New York State-approved syringe exchange programs (SEPs) and estimate the cost-saving potential of these programs...
  39. pmc Greater drug injecting risk for HIV, HBV, and HCV infection in a city where syringe exchange and pharmacy syringe distribution are illegal
    Alan Neaigus
    Institute for International Research on Youth at Risk, National Development and Research Institutes, 71 West 23rd Street, 8th Floor, New York, NY 10010, USA
    J Urban Health 85:309-22. 2008
    ..Legalizing and rapidly implementing sterile syringe distribution programs are critical for reducing parenterally transmitted HIV, HBV, and HCV among IDUs...
  40. ncbi Effectiveness of needle-exchange programmes for prevention of HIV infection
    S F Hurley
    Department of Public Health and Community Medicine, University of Melbourne, Australia
    Lancet 349:1797-800. 1997
    ..We used an ecological study design to compare changes over time in HIV seroprevalence in injecting drug users worldwide, for cities with and without NEPs...
  41. ncbi The impact of the Sydney Medically Supervised Injecting Centre (MSIC) on crime
    Karen Freeman
    NSW Bureau of Crime Statistics and Research, Level 8, St James Centre, 111 Elizabeth Street, Sydney, NSW 2000, Australia
    Drug Alcohol Rev 24:173-84. 2005
    ..These results suggest that setting up an MSIC does not necessarily lead to an increase in drug-related problems of crime and public loitering...
  42. ncbi My place, your place, or a safer place: the intention among Montréal injecting drug users to use supervised injecting facilities
    Traci C Green
    Department of Epidemiology and Biostatistics, McGill University, Montreal, Quebec
    Can J Public Health 95:110-4. 2004
    ..This study sought to assess the acceptability of SIF and to determine factors associated with willingness of injecting drug users (IDU) to use SIF in a city considering their establishment...
  43. ncbi Needle exchange programs. Delivery and access issues
    Carol J Strike
    Health Systems Research and Consulting Unit, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, ON M5S 2S1
    Can J Public Health 93:339-43. 2002
    ..Examine the challenges of four service delivery models (i.e., fixed, mobile, satellite and home visits) and how service delivery may impact on NEP HIV prevention efforts...
  44. ncbi Drug use and harm reduction policy: alternative perspectives on the California proposal
    Laura Stauffer
    Department of Social Welfare, University of California, Berkeley, CA 94720 7400, USA
    J Health Soc Policy 19:19-36. 2004
    ..This article underscores the relevance of syringe deregulation and its relevance as an ethical and political issue for social workers...
  45. ncbi Changes in the sharing of drug injection equipment among street-recruited injection drug users in Chicago, Illinois, 1994--1996
    Dezheng Huo
    Community Outreach Intervention Projects, Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, Illinois 60637, USA
    Subst Use Misuse 40:63-76. 2005
    ..Participation in a syringe exchange program was associated with reductions in receptive syringe sharing and syringe-mediated sharing, but not the sharing of cookers...
  46. ncbi Psychosocial and behavioral differences among drug injectors who use and do not use syringe exchange programs
    Lauretta E Grau
    Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, CT 06520 8034, USA
    AIDS Behav 9:495-504. 2005
    ..Implications for future interventions are discussed...
  47. ncbi Profiles of self-reported HIV-risk behaviors among injection drug users in methadone maintenance treatment, detoxification, and needle exchange programs
    Hayley Diana Mark
    Johns Hopkins University School of Nursing, Baltimore, MD 21205 2110, USA
    Public Health Nurs 23:11-9. 2006
    ....
  48. ncbi The HIV/AIDS epidemic and changes in injecting drug use in Buenos Aires, Argentina
    Diana Rossi
    Intercambios Asociación Civil para el Estudio y Atención de Problemas Relacionados con las Drogas, Buenos Aires, Argentina
    Cad Saude Publica 22:741-50. 2006
    ..Knowledge about these changes helps build harm reduction activities oriented to IDUs in their particular social context...
  49. ncbi Drug use and HIV risk practices of secondary and primary needle exchange users
    Dezheng Huo
    Division of Epidemiology and Biostatistics, Community Outreach Intervention Projects, School of Public Health, University of Illinois at Chicago, IL 60637, USA
    AIDS Educ Prev 17:170-84. 2005
    ..Secondary exchange facilitated HIV risk reduction but the salutary effects of NEPs were attenuated in mixed/secondary exchangers...
  50. ncbi Correlates of unsafe syringe acquisition and disposal among injection drug users in Baltimore, Maryland
    Elizabeth T Golub
    Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
    Subst Use Misuse 40:1751-64. 2005
    ..These data suggest the need for a more active program involving pharmacists, an expanded syringe access program, and better efforts to enhance safe disposal...
  51. ncbi Unmet need for recommended preventive health services among clients of California syringe exchange programs: implications for quality improvement
    K G Heinzerling
    UCLA Robert Wood Johnson Clinical Scholars Program, 911 Broxton Avenue, Third Floor, Los Angeles, CA 90024, USA
    Drug Alcohol Depend 81:167-78. 2006
    ..We examined use of recommended preventive services by clients of 23 SEPs throughout California...
  52. doi Coverage to curb the emerging HIV epidemic among injecting drug users in Pakistan: delivering prevention services where most needed
    Faran Emmanuel
    HIV AIDS Surveillance Project, National AIDS Control Program, Chak Shehzad Park Road, Islamabad 44400, Pakistan
    Int J Drug Policy 19:S59-64. 2008
    ....
  53. ncbi Patterns of drug use and associated harms among rural injecting drug users: comparisons with metropolitan injecting drug users
    Carolyn Day
    National Centre in HIV Epidemiology and Clinical Research, University of New South Wales, Darlinghurst, New South Wales, Australia
    Aust J Rural Health 14:120-5. 2006
    ....
  54. ncbi New York City injection drug users' memories of syringe-sharing patterns and changes during the peak of the HIV/AIDS epidemic
    Russell Rockwell
    National Development and Research Institutes Inc, New York, New York 10010, USA
    AIDS Behav 10:691-8. 2006
    ..IDUs remember when they first became aware of AIDS and began to adjust their behaviors and social assumptions...
  55. pmc Full participation in harm reduction programmes is associated with decreased risk for human immunodeficiency virus and hepatitis C virus: evidence from the Amsterdam Cohort Studies among drug users
    Charlotte Van Den Berg
    Department of Human Retrovirology, Center for Infection and Immunity Amsterdam, Academic Medical Center, Amsterdam, The Netherlands
    Addiction 102:1454-62. 2007
    ..To investigate the impact of harm-reduction programmes on HIV and hepatitis C virus (HCV) incidence among ever-injecting drug users (DU) from the Amsterdam Cohort Studies (ACS)...
  56. ncbi Determinants of injection drug user (IDU) syringe sharing: the relationship between availability of syringes and risk network member characteristics in Winnipeg, Canada
    Souradet Y Shaw
    Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
    Addiction 102:1626-35. 2007
    ..We examine the extent to which each of these variables is related independently to this behaviour within a diverse study population...
  57. ncbi Client satisfaction and risk behaviours of the users of syringe dispensing machines: a pilot study
    Mofizul Islam
    Faculty of Medicine, University of Sydney, Australia
    Drug Alcohol Rev 27:13-9. 2008
    ..The study examines risk behaviours of the users of syringe dispensing machines (SDMs) and evaluates the usefulness of these machines in providing injecting drug users (IDUs) with sterile injecting equipment...
  58. ncbi Childhood sexual and physical abuse histories, PTSD, depression, and HIV risk outcomes in women injection drug users: a potential mediating pathway
    Rosalyn E Plotzker
    Center for the Studies of Addiction, HIV Prevention Division, Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, USA
    Am J Addict 16:431-8. 2007
    ..01) and drug (p < 0.03) risk. After PTSD/depression adjustment, CSA was no longer associated with sexual or drug risk. These results suggest that women IDUs' CSA-to-risk path is mediated by PTSD/depression...
  59. doi Incidence of HIV, hepatitis C and hepatitis B viruses among injection drug users in southwestern China: a 3-year follow-up study
    Yuhua Ruan
    State Key Laboratory for Infectious Disease Prevention and Control, and National Center for AIDS STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
    AIDS 21:S39-46. 2007
    ..To investigate the incidence rates of HIV, hepatitis C virus (HCV), and hepatitis B virus (HBV) among injection drug users (IDU) in a drug trafficking city in southwest China...
  60. pmc High-prevalence and high-estimated incidence of HIV infection among new injecting drug users in Estonia: need for large scale prevention programs
    Anneli Uuskula
    Department of Public Health, University of Tartu, Ravila 19, 50411 Tartu, Estonia
    J Public Health (Oxf) 30:119-25. 2008
    ..Behavioral surveys were administered; serum samples were collected for HIV testing. Subjects were categorized into new injectors (injecting < or = 3 years) and long-term injectors (injecting > 3 years)...
  61. doi "I inject less as I have easier access to pipes": injecting, and sharing of crack-smoking materials, decline as safer crack-smoking resources are distributed
    Lynne Leonard
    Department of Epidemiology and Community Medicine, University of Ottawa, 451 Smyth Road, Ottawa, Ontario K1H 8M5, Canada
    Int J Drug Policy 19:255-64. 2008
    ..01). Since distributing safer crack-smoking materials by a NEP contributes to transition to safer methods of drug ingestion and significantly reduces disease-related risk practices, other NEPs should adopt this practice...
  62. doi Injection drug use in Rural Iran: integrating HIV prevention into iran's rural primary health care system
    Vahid Mojtahedzadeh
    Iranian National Center for Addiction Studies, Ministry of Health, Treatment and Medical Education, Tehran, Islamic Republic of Iran
    AIDS Behav 12:S7-12. 2008
    ..08, 95% CI 1.1-3.88). This project demonstrates that HIV risks exist in rural Iran and suggests the innovative use of Iran's rural health care system to extend prevention and treatment services to these populations...
  63. ncbi Minimal uptake of sterile drug preparation equipment in a predominantly cocaine injecting population: implications for HIV and hepatitis C prevention
    Carole Morissette
    Montreal Public Health Department, Division of Infectious Diseases, 1301 Sherbrooke Street East, Montreal, Quebec, H2L 1M3, Canada
    Int J Drug Policy 18:204-12. 2007
    ..To identify factors associated with using sterile drug injection equipment by injection drug users (IDUs)...
  64. ncbi Rapid scale up of harm reduction in China
    Sheena G Sullivan
    National Center for AIDS, STD Control and Prevention, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Beijing 100050, China
    Int J Drug Policy 18:118-28. 2007
    ..With their support, rapid scale-up to effectively reach a majority of drug users can be achieved in the coming years...
  65. pmc Deadly disregard: government refusal to implement evidence-based measures to prevent HIV and hepatitis C virus infections in prisons
    Richard Elliott
    Canadian HIV AIDS Legal Network, Toronto, Ont
    CMAJ 177:262-4. 2007
  66. ncbi Social context of needle selling in Baltimore, Maryland
    Carl A Latkin
    Faculty of Social and Behavioral Sciences, Department of Health Policy and Management, Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD 21205, USA
    Subst Use Misuse 41:901-13. 2006
    ..the debate surrounding the distribution of sterile syringes to injection drug users (IDUs) has focused on needle exchange programs (NEPs), IDUs acquire their syringes from three major sources: NEPs, pharmacies, and secondary exchangers ..
  67. ncbi Needle exchange and injection-related risk behaviors in Chicago: a longitudinal study
    Dezheng Huo
    Department of Health Studies, University of Chicago, 5841 South Maryland Avenue, MC2007, Chicago, IL 60637, USA
    J Acquir Immune Defic Syndr 45:108-14. 2007
    ..To examine whether needle exchange program (NEP) use by injecting drug users (IDUs) affects injection risk behaviors over time...
  68. ncbi Psychiatric comorbidity is associated with drug use and HIV risk in syringe exchange participants
    Elizabeth Disney
    Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, Baltimore, Maryland, USA
    J Nerv Ment Dis 194:577-83. 2006
    ....
  69. ncbi Needle exchange use, sexual risk behaviour, and the prevalence of HIV, hepatitis B virus, and hepatitis C virus infections among Bulgarian injection drug users
    Z P Vassilev
    Department of Preventive Medicine and Community Health, New Jersey Medical School, Newark, NJ, USA
    Int J STD AIDS 17:621-6. 2006
    ..As 40% of the IDUs reported using NEP, it appears that needle exchange provides an opportunity to reach high-risk populations and prevent sexual transmission of blood-borne pathogens...
  70. ncbi [Pharmacy syringe exchange program for injection drug users]
    Nicolas Bonnet
    Apothicom, Ivry sur Seine
    Presse Med 35:1811-8. 2006
    ..To demonstrate that a syringe exchange program can reduce syringe re-use, to encourage HCV screening by injection drug users (IDUs), and to provide a new harm reduction tool through the pharmacy network...
  71. ncbi Changing patterns of cocaine use and hiv risks in the south of Brazil
    James A Inciardi
    Center for Drug and Alcohol Studies, University of Delaware, Coral Gables, FL, USA
    J Psychoactive Drugs 38:305-10. 2006
    ..Within this context, this article describes the qualitative data describing the decline of cocaine injecting and the corresponding emergence of crack use in Porto Alegre, Brazil, and related HIV risks...
  72. ncbi Changes in injecting practices associated with the use of a medically supervised safer injection facility
    Jo Anne Stoltz
    Clinical Activities, British Columbia Centre of Excellence in HIV AIDS, University of British Columbia, Vancouver, Canada
    J Public Health (Oxf) 29:35-9. 2007
    ....
  73. ncbi Unstable housing as a factor for increased injection risk behavior at US syringe exchange programs
    Don C Des Jarlais
    Baron Edmond de Rothschild Chemical Dependency Institute, Beth Israel Medical Center, New York, NY 10038, USA
    AIDS Behav 11:78-84. 2007
    ..To assess variation in injection risk behavior among unstably housed/homeless injecting drug users (IDUs) across programs in a national sample of US syringe exchange programs...
  74. ncbi The art and the science of scaling-up needle and syringe programmes
    Richard Bedell
    Addiction 102:1179-80. 2007
  75. pmc The role of harm reduction in controlling HIV among injecting drug users
    Alex Wodak
    Alcohol and Drug Service, St Vincent s Hospital, Darlinghurst, New South Wales, Australia
    AIDS 22:S81-92. 2008
    ..Sometimes zealous drug law enforcement undermines harm reduction. A more balanced approach to drug law enforcement is required with illicit drug use recognized primarily as a health and social problem...
  76. pmc Estimation of the number of injecting drug users attending an outreach syringe-exchange program and infection with human immunodeficiency virus (HIV) and hepatitis C virus: the AjUDE-Brasil project
    Waleska Teixeira Caiaffa
    Department of Preventive and Social Medicine, School of Medicine, Federal University of Minas Gerais State, Av Alfredo Balena, 190, Caixa Postal 340, 30 130 100 Belo Horizonte, MG, Brazil
    J Urban Health 80:106-14. 2003
    ....
  77. ncbi Syringe access for injection drug users in Rhode Island
    Amy Boutwell
    Brown Medical School, Providence, RI, USA
    Med Health R I 87:15-6. 2004
  78. ncbi Safer injection facilities (SIFs) for injection drug users (IDUs) in Canada. A review and call for an evidence-focused pilot trial
    Benedikt Fischer
    Centre for Addiction and Mental Health, 33 Russell Street, Room 2036, Toronto, ON M5S 2S1
    Can J Public Health 93:336-8. 2002
  79. ncbi The injection of methadone syrup in New South Wales: patterns of use and increased harm after partial banning of injecting equipment
    Max Hopwood
    National Centre in HIV Social Research, University of New South Wales
    Aust N Z J Public Health 27:551-5. 2003
    ..To assess the impact on injecting drug use and risk behaviour of the withdrawal of methadone injecting equipment from government-funded needle and syringe programs...
  80. ncbi Demystifying the injection drug user: willingness to participate in traditional drug treatment services among participants in a needle exchange program
    Samuel A MacMaster
    University of Tennessee, College of Social Work, Nashville 37210, USA
    J Psychoactive Drugs 34:289-94. 2002
    ....
  81. ncbi Syringe exchange
    Riki Jacobs
    N J Med 100:55-9; quiz 79-80. 2003
  82. pmc An external evaluation of a peer-run "unsanctioned" syringe exchange program
    Evan Wood
    British Columbia Centre for Excellence in HIV AIDS, St Paul s Hospital, Vancouver, BC, Canada BC V6Z 1Y6
    J Urban Health 80:455-64. 2003
    ..The findings also suggest that other forms of syringe-exchange programs should consider the benefits of offering fixed site nighttime service...
  83. pmc Epidemiology of HIV/AIDS, hepatitis B, hepatitis C, and tuberculosis among minority injection drug users
    Antonio L Estrada
    Mexican American Studies and Research Center, University of Arizona, Economics Building, 23, Tucson, AZ 85723, USA
    Public Health Rep 117:S126-34. 2002
    ..This article reviews the literature on the impact of HIV/AIDS, hepatitis B and C viruses (HBV, HCV), and tuberculosis on minority drug injectors in the United States...
  84. ncbi HIV and hepatitis C virus risk in new and longer-term injecting drug users in Oslo, Norway
    Maureen Miller
    Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York 10032, USA
    J Acquir Immune Defic Syndr 33:373-9. 2003
    ..2; 95% confidence interval = 0.1-0.4). Increased similarity in age between new and longer-term IDUs may have contributed to the rapid spread of HCV infection by facilitating mixing patterns between HCV-infected and -susceptible IDUs...
  85. ncbi Situational factors influencing drug injecting, risk reduction and syringe exchange in Togliatti City, Russian Federation: a qualitative study of micro risk environment
    Tim Rhodes
    Department of Social Science and Medicine, The Centre for Research on Drugs and Health Behaviour, University of London, Reynolds Building, St Dunstan s Road, SW6 8RP, London, UK
    Soc Sci Med 57:39-54. 2003
    ..We note the role of policing practices in influencing risk reduction and the potential role of policing agencies in supporting HIV prevention initiatives among IDUs...
  86. ncbi The potential public health and community impacts of safer injecting facilities: evidence from a cohort of injection drug users
    Evan Wood
    British Columbia Center for Excellence in HIV AIDS, St Paul s Hospital, British Columbia, Canada
    J Acquir Immune Defic Syndr 32:2-8. 2003
    ..Specifically, it is presently unknown if those at greatest risk of overdose and HIV transmission or those responsible for community impact of injection drug use will be willing to attend...
  87. ncbi Investigation of a secondary syringe exchange program for homeless young adult injection drug users in San Francisco, California, U.S.A
    C Sears
    Department of Sociology, University of California-Santa Cruz, Santa Cruz, CA, USA
    J Acquir Immune Defic Syndr 27:193-201. 2001
    ..825; 95% CI, 1.392- 16.721). This suggests that the intervention was effective in delivering SEP services to homeless young adult IDUs, and that IDUs who frequented the intervention site had a lower HIV risk than comparison group IDUs...
  88. ncbi HIV risk practices among needle exchange users and nonusers in Chicago
    Lawrence Ouellet
    Division of Epidemiology and Biostatistics, Community Outreach Intervention Projects, School of Public Health, University of Illinois at Chicago, USA
    J Acquir Immune Defic Syndr 37:1187-96. 2004
    ..To assess associations between needle exchange program (NEP) use and drug injection risk practices...
  89. ncbi Exploring the role of needle selling in a drug-using community in Baltimore, Maryland
    Carl A Latkin
    Johns Hopkins University, Bloomberg School of Public Health, Department of Health Policy and Management, Baltimore, MD, USA
    J Acquir Immune Defic Syndr 38:57-60. 2005
    b>Needle exchange programs (NEPs) play a critical role in reducing the spread of HIV in injection drug users (IDUs). However, many IDUs do not access NEPs and rely on needle sellers...
  90. ncbi Why New Jersey needs to change its syringe access laws
    Joseph J Roberts
    New Jersey State Assembly, USA
    N J Med 101:35-6. 2004
  91. ncbi Unsafe injecting practices among attendees of syringe exchange programmes in France
    M Valenciano
    Institut de Veille Sanitaire, St-Maurice, France
    Addiction 96:597-606. 2001
    ..Interventions should stress the importance of using sterile material for each injection, even with a steady sex partner...
  92. ncbi Long-term effects of syringe exchange on risk behavior and HIV prevention
    Naomi Braine
    The Baron Edmond de Rothschild Chemical Dependency Institute, Beth Israel Medical Center, New York, NY 10003, USA
    AIDS Educ Prev 16:264-75. 2004
    ..This study confirms previous findings that SEPs can play a significant role in the prevention of HIV in marginal and impoverished communities in the United States...
  93. ncbi Syringe exchange proposal
    Riki E Jacobs
    N J Med 99:33-4. 2002
  94. ncbi Multiperson use of syringes among injection drug users in a needle exchange program: a gene-based molecular epidemiologic analysis
    Sadeep Shrestha
    Laboratory of Genomic Diversity, National Cancer Institute, NCI Frederick, MD 21702, USA
    J Acquir Immune Defic Syndr 43:335-43. 2006
    ..Testing of STRs represents a promising approach to examining and accessing complex behavioral data, including syringe sharing...
  95. ncbi Injection risk behaviors among clients of syringe exchange programs with different syringe dispensation policies
    Alex H Kral
    Urban Health Study, Department of Family and Community Medicine, University of California, San Francisco, CA 94110, USA
    J Acquir Immune Defic Syndr 37:1307-12. 2004
    ..It is concluded that SEPs that base syringe dispensation policy upon need may facilitate reductions in reuse of syringes...
  96. ncbi [Drug addiction: harm reduction policies in France and Spain]
    Angela Ramirez-Jonville
    Université de Médecine Pierre et Marie Curie, Paris, France
    Presse Med 35:1151-61. 2006
    Harm reduction policies, such as needle exchange programs, injection centers, and substitution treatments, attempt to reduce the health and social damage associated with illegal drug use...
  97. ncbi [Sharing of needles and paraphernalia injection in new and long-term injection drug users in Sichuan, China]
    Jian bo Liu
    School of Public Health, Hebei Medicine University, Shijiazhuang, China
    Zhonghua Liu Xing Bing Xue Za Zhi 30:656-62. 2009
    ..To examine the prevalence and correlates for needle-sharing among new and long-term injection drug users (IDUs) in Sichuan province, China...
  98. pmc Syringe prescription to prevent HIV infection in Rhode Island: a case study
    J D Rich
    Miriam Hospital, Brown University School of Medicine, Providence, RI 02906, USA
    Am J Public Health 91:699-700. 2001
    ..Previously tried strategies include needle exchange programs and changing laws to allow the legal purchase and possession of syringes...
  99. pmc Characterization of the emerging HIV type 1 and HCV epidemics among injecting drug users in Dushanbe, Tajikistan
    Chris Beyrer
    Johns Hopkins Bloomberg School of Public Health, Department of Epidemiology, Baltimore, Maryland 21205, USA
    AIDS Res Hum Retroviruses 25:853-60. 2009
    ..Targeted prevention programs offering both needle exchange programs and opiate substitution therapies are urgently called for to prevent the further spread of HIV and HCV in ..
  100. ncbi High street prices of syringes correlate with strict syringe possession laws
    J D Rich
    The Miriam Hospital and Brown University, Providence, Rhode Island, USA
    Am J Drug Alcohol Abuse 26:481-7. 2000
    ..We surveyed 42 needle exchange programs (NEPs) in the United States in July and August 1998 to determine the street prices of syringes...
  101. pmc Giving away used injection equipment: missed prevention message?
    Carol Strike
    Centre for Addiction and Mental Health, 33 Russell Street, Toronto, Ontario, Canada
    Harm Reduct J 7:2. 2010
    Our objective was to examine factors associated with distributive injection equipment sharing and how needle exchange programs (NEPs) can help reduce distributive sharing among injection drug users (IDUs).

Research Grants96

  1. Characterizing fatal heroin overdose and neighborhood context in Baltimore
    LINDSAY JORGENSEN; Fiscal Year: 2007
    ..The proposed study could inform appropriate geographic locations for expanding overdose prevention and needle exchange programs in Baltimore, as well as provide an in-depth understanding of the spatial distribution and related ..
  2. Monitoring Atypical HIV Strains Among Persons Newly Dia*
    Carol Ciesielski; Fiscal Year: 2007
    ..Location types include hospitals, neighborhood clinics, community centers, late-night street corners, needle exchange programs, outreach sites, and drug rehabilitation centers...
  3. Post-trial HIV Vaccines: Receptivity, Risk & Disparities
    William Cunningham; Fiscal Year: 2007
    ..diverse persons attending three types of venues in Los Angeles: Sexually Transmitted Disease Clinics, Needle Exchange Programs, and Latino Community Health and HIV Prevention Clinics...
  4. Drug Reduction Intervention for Needle Exchange Clients
    Aruna Gogineni; Fiscal Year: 2003
    ..have examined the likelihood that using a brief motivation based intervention with drug users enrolled in needle exchange programs may improve drug use outcomes...
  5. Statistical Methods for Partially Controlled Studies
    Ronald Brookmeyer; Fiscal Year: 2003
    ..This work will be applied to ongoing needle exchange programs in Baltimore, for preventing HIV transmission...
  6. Statistical Methods for Partially Controlled Studies
    Constantine Frangakis; Fiscal Year: 2005
    ..This work will be applied to ongoing needle exchange programs in Baltimore, for preventing HIV transmission...
  7. Statistical Designs and Methods for Partially Controlled HIV/AIDS Studies
    Constantine Frangakis; Fiscal Year: 2007
    ..The proposed methods are developed for two broad aims, and are motivated by needle exchange programs in the US, HIV treatment administration in East Africa, and HIV vaccine efficacy trials...
  8. Statistical Designs and Methods for Partially Controlled HIV/AIDS Studies
    Constantine E Frangakis; Fiscal Year: 2010
    ..The proposed methods are developed for two broad aims, and are motivated by needle exchange programs in the US, HIV treatment administration in East Africa, and HIV vaccine efficacy trials...
  9. Syntheses of HIV Prevention Research, Phase III
    Blair T Johnson; Fiscal Year: 2010
    ..affect the availability of preventative actions, including condom availability and condom-use policies needle exchange programs, and increases in services for sexually transmitted infections...
  10. Syntheses of HIV Prevention Research, Phase III
    Blair T Johnson; Fiscal Year: 2010
    ..affect the availability of preventative actions, including condom availability and condom-use policies needle exchange programs, and increases in services for sexually transmitted infections...
  11. Syntheses of HIV Prevention Research, Phase III
    Blair Johnson; Fiscal Year: 2009
    ..affect the availability of preventative actions, including condom availability and condom-use policies needle exchange programs, and increases in services for sexually transmitted infections...
  12. MAINTAINING HIV RISK REDUCTION AMONG NEEDLE EXCHANGERS
    Michael Stein; Fiscal Year: 2004
    ..b>Needle exchange programs offer direct contact with drug users who have initiated HIV risk reduction...
  13. Replication Study of Breast Cancer Susceptibility Genes in Blacks
    Dezheng Huo; Fiscal Year: 2010
    ..This study will advance understanding the genetic risk factors for breast cancer in women of African descent and will be invaluable in developing novel prevention strategies in the future. ..
  14. Replication Study of Breast Cancer Susceptibility Genes in Blacks
    Dezheng Huo; Fiscal Year: 2009
    ..This study will advance understanding the genetic risk factors for breast cancer in women of African descent and will be invaluable in developing novel prevention strategies in the future. ..
  15. The Impact of Neighborhoods, Networks and Depression on Drug Users' HIV Risks
    Carl Latkin; Fiscal Year: 2007
    ..In addition to survey data, observer ratings of neighborhoods, police crime reports, and census data will be collected. Hierarchical Linear Modeling and Structural Equations Modeling will be used for data analysis. ..
  16. Mid-Career Investigator Award in Substance Abuse - Research
    Michael Stein; Fiscal Year: 2007
    ..Stein's interest in translating this research to primary care and substance abuse treatment settings while mentoring new clinical investigators. ..
  17. HIV Prevention and Adherence Intervention for HIV Positives and Partners in India
    Carl Latkin; Fiscal Year: 2009
    ..PUBLIC HEALTH RELEVANCE: This proposal has high public relevance due to the low rates of HIV medication adherence found in many impoverished communities domestically and internationally. ..
  18. COMMUNITY BASED INTERVENTION AT NEEDLE EXCHANGE SITES
    Michael Kidorf; Fiscal Year: 2001
    b>Needle exchange programs were designed to provide injection drug users with ready access to sterile needles and syringes to reduce the frequency of sharing contaminated equipment and thereby lower the risk of transmitting HIV and other ..
  19. Environmental Factors in HIV Transmission among Suburban IDUs
    Robert Heimer; Fiscal Year: 2010
    ....
  20. Integrating Sex & Drug Related HIV Risk & Transmission
    Robert Heimer; Fiscal Year: 2007
    ..abstract_text> ..
  21. SYRINGE EXCHANGE BASED HEPATITIS B VACCINATION OF IDU'S
    Robert Heimer; Fiscal Year: 2005
    ....
  22. Community-Based Intervention at Needle Exchange Sites
    Michael Kidorf; Fiscal Year: 2006
    Participation in needle exchange programs (NEPs) is associated with increased use of sterile syringes, reduction in high-risk drug injection behaviors, and lower incidence of HIV seroconversion...
  23. Malt beverage use & outcomes in a minority community
    Ricky Bluthenthal; Fiscal Year: 2002
    ....
  24. COMMUNITY CONTEXT, SEP OPERATIONS, & HIV RISK AMONG IDUs
    Ricky Bluthenthal; Fiscal Year: 2005
    ..abstract_text> ..
  25. Antidepressants During Office-based Buprenorphine
    Michael Stein; Fiscal Year: 2007
    ..The focus of this study, the evaluation of combinations of medications, to treat substance-related disorders, fits squarely within the emphasis of this RFA. ..
  26. Understanding Outcome Disparities in Alcohol Treatment
    Ricky Bluthenthal; Fiscal Year: 2005
    ..geographic location, and treatment program and racial disparities in treatment outcomes; (2) to determine if the patterns of disparities in treatment outcomes differ by gender and by race for African Americans, Latinos and Caucasians ..
  27. A TRIAL TO REDUCE HEPATITIS C AMONG INJECTION DRUG USERS
    Michael Stein; Fiscal Year: 2003
    ..abstract_text> ..
  28. ANTIDEPRESSANT TREATMENT TO REDUCE HIV RISK AMONG IDUS
    Michael Stein; Fiscal Year: 2002
    ..abstract_text> ..
  29. Adapting to HIV Disease--A Family Intervention
    Michael Stein; Fiscal Year: 2004
    ..Given the significance of families in the AIDS epidemic, it is important to study as well as support families and patients to optimize care of those affected by HIV disease. ..
  30. THE LONG-TERM IMPACT OF A NETWORK OUTREACH INTERVENTION
    Carl Latkin; Fiscal Year: 2002
    ..The data will also used to examine associations between characteristics of sex partners and personal networks to describe sexual mixing patterns of this population. ..
  31. A Network Intervention for Reducing Sexual Risk for HIV with African American MSM
    Carl Latkin; Fiscal Year: 2007
    ..Urinalysis of gonorrhea and chlamydia at baseline and follow-up will be used as additional measures of sex risk. We will also assess potential diffusion of intervention effects to participants' social network members. ..