***TASK*** the task is to summarize an input biomedical literature in six sentences 
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    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: Objective To evaluate the effectiveness of relapse prevention ( RP ) and brief intervention ( BI ) in reducing HIV risk-taking behaviours among injecting drug users ( IDU ) enrolled in methadone programmes . The hypotheses tested were : ( 1 ) that a six-session RP programme would be more effective in reducing HIV risk-taking behaviours than a one-session BI and a non-intervention control condition ( C ) ; and ( 2 ) that Bl would be more effective in reducing HIV risk-taking behaviours than C. Design Clients of methadone programmes were r and omly assigned to either RP , Bl , or C. Follow-up occurred 6 months after pre-intervention assessment and was conducted by independent research assistants who were not aware of subjects ' group allocations . Setting Confidential assessment interviews and interventions generally took place at the methadone unit treating the subject . Participants Ninety-five IDU enrolled in methadone programmes . Study entry criteria were : injection of any drug in the 6 months before the day of pre-intervention assessment ; literacy in English ; agreement to HIV-antibody testing for research purpose s ; and no known diagnosis of a serious mental illness . Eighty subjects were contacted successfully for a 6-month follow-up . Interventions The RP intervention was a six-session programme . Each 60–90-min session was conducted individually . The Bl was a one-session motivational interview lasting 60–90 min , accompanied by a self-help booklet . Main outcome measures All subjects were administered the Drug Use Scale and HIV Risk-Taking Behaviour Scale of the Opiate Treatment Index and consented to the collection of a capillary blood sample for HIV-antibody testing at pre-intervention assessment and follow-up . At follow-up , the Highest HIV Risk-Taking Behaviour Scale , collateral reports from subjects ' sexual partners pertaining to the previous month and urinalysis results for the month before follow-up were collected . Results Compliance with interventions was good . Correspondence of self-reports with urinalysis and collateral reports was satisfactory . There were no significant differences between groups in risk-taking behaviours during the month before follow-up . However , there was evidence of a lower rate of needle-risk behaviour ( sharing and cleaning ) during the heaviest risk-taking month since pre-intervention assessment in the group given RP . There were no indications that Bl was of greater benefit than the usual methadone treatment and neither intervention appeared to reduce sexual risk behaviour . Conclusions The results are cautiously interpreted as showing that individual RP programmes decrease the level of needle-risk behaviour during relapse episodes , but further research is required to replicate this finding Peer outreach models have been successful in addressing  HIV risk behaviors of drug users . Patients in methadone maintenance treatment programs who were migrants from Puerto Rico and /or familiar with drug use there were trained to conduct HIV-related peer outreach . A group r and omized design was implemented ; patients in the Experimental ( E ) condition ( n = 80 ) received training and conducted 12 weeks of outreach .  Half of the patients completed the training and outreach . At follow-up , patients in the E condition who conducted outreach felt they were more helpful to their community , showed a trend for engaging in more vocational activities , and were more likely to talk with others about HIV , compared to those who did not conduct outreach and those in the Control condition ( n = 78 ) . Drug treatment patients who are migrants can be trained as peer outreach workers and short-term benefits were found . Longer term maintenance of benefits should be assessed OBJECTIVES This study evaluated a theory-based community-level intervention to promote progress toward consistent condom and bleach use among selected population s at increased risk for HIV infection in 5 US cities . METHODS Role-model stories were distributed , along with condoms and bleach , by community members who encouraged behavior change among injection drug users , their female sex partners , sex workers , non-gay-identified men who have sex with men , high-risk youth , and residents in areas with high sexually transmitted disease rates . Over a 3-year period , cross-sectional interviews  ( n = 15,205 ) were conducted in 10 intervention and comparison community pairs . Outcomes were measured on a stage-of-change scale . Observed condom carrying and intervention exposure were also measured . RESULTS At the community level , movement toward consistent condom use with main ( P < .05 ) and nonmain ( P < .05 ) partners , as well as increased condom carrying ( P < .0001 ) , was greater in intervention than in comparison communities . At the individual level , respondents recently exposed to the intervention were more likely to carry condoms and to have higher stage-of-change scores for condom and bleach use . CONCLUSIONS The intervention led to significant communitywide progress toward consistent HIV risk reduction AIM To assess the effectiveness of a  sexual risk reduction intervention in the Russian narcology hospital setting . DESIGN , SETTING AND PARTICIPANTS This was a r and omized controlled trial from October 2004 to December 2005 among patients with alcohol and /or heroin dependence from two narcology hospitals in St Petersburg , Russia . INTERVENTION Intervention subjects received two personalized sexual behavior counseling sessions plus three telephone booster sessions . Control subjects received usual addiction treatment , which did not include sexual behavior counseling . All received a research assessment and condoms at baseline . MEASUREMENTS Primary outcomes were percentage of safe sex episodes ( number of times condoms were used / by number of sexual episodes ) and no unprotected sex ( 100 % condom use or abstinence ) during the previous 3 months , assessed at 6 months . FINDINGS Intervention subjects reported higher median percentage of safe sex episodes ( unadjusted median difference 12.7 % ; P = 0.01 ; adjusted median difference 23 % , P = 0.07 ) ; a significant difference was not detected for the outcome no unprotected sex in the past 3 months [ unadjusted odds ratio ( OR ) 1.6 , 95 % confidence interval ( CI ) 0.8 - 3.1 ; adjusted OR 1.5 , 95 % CI 0.7 - 3.3 ] . CONCLUSIONS Among Russian substance-dependent individuals , sexual behavior counseling during addiction treatment should be considered as one potential component of efforts to decrease risky sexual behaviors in this HIV at-risk population This study examined and compared the effectiveness of two counseling interventions design ed to reduce the HIV drug and sexual risk behaviors of 684 out-of-treatment drug users recruited from South Philadelphia , PA . All study participants received a st and ard intervention and one half were r and omly assigned to also receive the enhanced intervention . The st and ard intervention provided  HIV risk reduction education , HIV testing with pretest and posttest counseling , and training in condom use and needle cleaning .  The enhanced intervention provided additional information on STD risk reduction . Both interventions were effective in influencing behavior change between baseline and 6-month follow-up . A higher proportion of persons reduced their drug risk behaviors compared to their sexual risk behaviors . As sexual risk behaviors are more resistant to change , there is a need for tailored interventions that target out-of-treatment drug users Many early studies of injecting drug users ( IDUs ) suggested that most HIV infections in this population were due to needle sharing and that sexual transmission was negligible or was overshadowed by parenteral routes . A few of the early studies suggested a potentially important role for heterosexual transmission , but these tended to be limited to cross-sectional data or had only a few years of prospect i ve follow-up . Studies of sexual risk factors for HIV infection among non-injecting drug users ( NIDUs ) are similarly sparse . Recently , investigators prospect ively examined both drug-related and sexual risk factors for HIV seroconversion among male and female IDUs with an adequate number of person-years to identify statistically significant associations . Other studies among never and former IDUs have identified associations suggesting that sexual transmission accounts for a substantial number of HIV seroconversions in these population s. Herein , highlights are discussed from recent investigations among IDUs in Baltimore , Maryl and , and corroborating findings from the literature . Results from a 10-year prospect i ve analysis of the ALIVE study and an analysis of the REACH studies spanning a 7-year period indicate that sexual risk factors for HIV infection are important in both female and male IDUs . These findings underscore the need for HIV interventions among drug users that incorporate sexual risk reduction . Based on the existing literature , a narrow focus on injection-related risks is an ineffective prevention strategy . Interventions that target specific subgroups of high-risk IDUs , such as men who have sex with men and inject drugs ( MSM-IDUs ) , sex worker-IDUs and HIV-infected IDUs , deserve special attention OBJECTIVES We compared the effects of 2 interventions on alcohol use , use of a new syringe at last injection , and condom use at last sexual encounter in a community sample of injection drug users . METHODS Between 2003 and 2006 , 851 out-of-treatment injection drug users were recruited in Raleigh , NC , and Durham , NC , through street outreach and were r and omly assigned to either a 6-session educational intervention or a 6-session motivational intervention . Intervention effects were examined at 6 and 12 months after enrollment . RESULTS In multiple logistic regression analyses adjusted for baseline alcohol use and HCV status , participants assigned to the motivational intervention were significantly less likely than were participants in the educational intervention to be drinking at the 6-month follow-up ( odds ratio = 0.67 ; 95 % confidence interval = 0.46 , 0.97 ) . There were no significant between-group differences in use of a new syringe at last injection or condom use at last sexual encounter at either follow-up . CONCLUSIONS Reducing alcohol use among persons with HCV may slow disease progression and provide important health benefits . Additional strategies are needed for slowing HCV disease progression until more effective HCV treatments are available BACKGROUND Interventions are needed to assist drug abusers in reducing risky drug and sexual behavior . METHODS A r and omized controlled trial compared three small-group AIDS educational interventions among 567 clients of a 21-day inpatient drug detoxification program :  a two-session informational intervention , given either during the first ( early ) or second ( late ) week of treatment ; and a six-session enhanced intervention . Changes in knowledge , attitudes , and psychomotor skills were assessed before and after each intervention , and behavioral outcomes were assessed at follow-up 10 to 18 weeks after admission . RESULTS Immediately after the interventions , enhanced group members reported significantly greater self-efficacy to talk themselves out of AIDS-risky behavior ; other knowledge and attitude scales did not differ by intervention . At follow-up , significant reductions in risky drug use were reported by all groups . Enhanced group members reported significantly greater reduction in injection frequency than did late informational subjects . CONCLUSIONS No beneficial effect was detected of delaying AIDS education for clients entering detoxification . At this early stage of follow-up , there is only weak evidence that an enhanced intervention improved outcomes Methadone maintenance programs ( MMP ) have the potential to play an important role in reducing HIV risk , given the appropriate type and level of ancillary treatments . In this study , we investigated the efficacy of a 12-session harm reduction group intervention for injection drug users , based upon the Information-Motivation-Behavioral skills model of behavior change , that focused on reducing both drug and sex risk . Two hundred and twenty patients entering an MMP were r and omized to receive either st and ard care (SC)-2 hours of counseling per month and a single-session risk reduction intervention-or SC plus the harm reduction group ( HRG ) . Results showed that during treatment , patients receiving HRG were more likely to be abstinent from cocaine and to report fewer unsafe sexual practice s. Post-treatment , HRG patients scored higher on a sexual risk quiz and reported increased self-efficacy in high risk sexual situations . Enhancing methadone maintenance with a weekly harm reduction group treatment was somewhat more expensive but can bring about positive changes in behaviors and attitudes that are associated with the transmission of HIV BACKGROUND Methamphetamine use has been associated with rising STI/HIV transmission rates , particularly among men who have sex with men ( MSM ) . Interventions which successfully reduce risk for HIV transmission among this population are a public health priority . This study examined the efficacy of a behavioral intervention for increasing safer sex behaviors in the context of ongoing methamphetamine use in a sample of HIV-positive , methamphetamine-using MSM . METHODS Three-hundred and forty-one participants from San Diego , CA were r and omly assigned to receive either a safer sex behavioral intervention ( EDGE ) or a time-equivalent diet- and -exercise attention-control condition . R and om effects regression analyses were used to evaluate change in safer sex behaviors over a 12-month period . RESULTS Participants in the EDGE intervention engaged in significantly more protected sex acts at the 8-month ( p=0.034 ) and 12-month assessment ( p=0.007 ) . By 12-months post-baseline , a greater percentage of protected sex acts was observed for EDGE ( 25.8 % ) vs. control participants ( 18.7 % ) ( p=0.038 ) . There was a significant time-by-intervention interaction ( p=0.018 ) for self-efficacy for condom use , suggesting that EDGE participants ' self-efficacy demonstrated a greater increase over time compared to control participants . CONCLUSIONS These results suggest that it is possible to reduce high risk sexual behaviors in the context of ongoing methamphetamine use among HIV-infected MSM A community-based HIV intervention for African-American women who are active injection drug users ( IDUs ) was evaluated . Seventy-one women ( aged 20–54 years ) were r and omly assigned to one of two enhanced gender- and culturally specific intervention conditions 
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Comparison with previous meta-analyses suggested limited progress in recent years in developing more effective interventions .
Multisession psychosocial and educational interventions provided similar modest sexual risk reduction justifying offering educational interventions in setting s with limited exposure to sexual risk reduction interventions , messages , and re sources