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Background: Intervention packages may result in a greater public health impact than single interventions. Understanding the separate impact of each component on the overall package effectiveness can improve intervention delivery. Methods: We adapted an approach to evaluate the effects of a time-varying intervention package in a network-randomized study. In some network-randomized studies, only a subset of participants in exposed networks receive the intervention themselves. The spillover effect contrasts average potential outcomes if a person was not exposed to themselves under intervention in the network versus no intervention in a control network. We estimated the effects of components of the intervention package in HIV Prevention Trials Network 037, a Phase III network-randomized HIV prevention trial among people who inject drugs and their risk networks using marginal structural models to adjust for time-varying confounding. The index participant in an intervention network received a peer education intervention initially at baseline, then boosters at 6 and 12 months. All participants were followed to ascertain HIV risk behaviors. Results: There were 560 participants with at least one follow-up visit, 48% of whom were randomized to the intervention, and 1,598 participant visits were observed. The spillover effect of the boosters in the presence of initial peer education training was a 39% rate reduction (rate ratio = 0.61; 95% confidence interval = 0.43, 0.87). Conclusions: These methods will be useful for evaluating intervention packages in studies with network features. [ABSTRACT FROM AUTHOR]

The article presents a study on the risk factors of group sex events (GSEs) in acquiring sexually transmitted infection (STI) and HIV in Brooklyn, New York. The study aims to describe the prevalence of HIV and STI among GSEs and GSE attendees. It also describes the characteristics of individual and network of GSEs and GSE attendees through the respondents sera and urine samples. The study concluded that self-reported GSE attendance and participation were usual among the high-risk urban network.

Examines how risk networks contribute to racial/ethnic variations in HIV prevalence among injection drug users. Racial and ethnic variations in background variables and individual risk behaviors; Analysis of HIV serostatus; Multivariate analysis of racial and ethnic variations in HIV seroprevalence.

Background: Sex risks and drug use are related. This relation in youth is described.Goal: To determine how stigmatized drug use is related to sexual risk behaviors and network characteristics among youth.Study Design: In-person interviews were conducted with both a probability household sample (n = 363) and a targeted, street-recruited sample of cocaine, heroin, crack, or injected drug users (n - 165) comprising 18- to 24-year-olds in an inner city neighborhood. Drug use in the preceding 12 months was scaled hierarchically, lowest to highest social stigma, as none, marijuana, noninjected cocaine, noninjected heroin, crack, and injected drugs.Results: Users of the more stigmatized drugs had more sex partners. They were more likely to report a history of concurrent sex partners, sex with someone who also had engaged in sex with a network member, commercial sex work, and unprotected sex. Findings showed crack use and drug injection to be associated more strongly with increased sex risk among women than among men.Conclusions: Young users of the more stigmatized drugs are at much greater network and behavior risk for sexually transmitted diseases. Drug use prevention, harm reduction interventions, or both may lower this risk. [ABSTRACT FROM AUTHOR]

Provides information on a study which examined the HIV risk behavior and HIV infection among initiates into illicit drug injection in New York, New York. Methods used in the study; HIV risk behaviors; HIV seroprevalence.

Examines the results of a study which investigated the risk of being infected with HIV infection, among people who are injecting drug users (IDUs) and who share syringes in New York City. Prevalence of HIV infection among IDUs; Previous research on HIV risk factors among drug injectors; Relationship between syringe sharing and HIV.

Presents information on a survey which focuses on drug use and sexually transmitted diseases among youth who reside in high-risk neighborhoods. Who conducted the survey; Objectives of the survey; Methods used to collect data; Results of the survey.

Editorial. Focuses on human immunodeficiency virus networks and other infections. Effect of location in a social network to risk behaviors and the characteristics of personal networks; Termination of epidemic outbreaks by the use of data on social contacts; Development of effective social and behavioral interventions.

Objective: To compare HIV prevalence among injecting and non-injecting heroin and cocaine users in New York City. As HIV is efficiently transmitted through the sharing of drug-injecting equipment, HIV infection has historically been higher among injecting drug users., Design: Two separate cross-sectional surveys, both with HIV counseling and testing and drug use and HIV risk behavior questionnaires., Methods: Injecting and non-injecting heroin and cocaine users recruited at detoxification and methadone maintenance treatment from 2001-2004 (n = 2121) and recruited through respondent-driven sampling from a research storefront in 2004 (n = 448)., Results: In both studies, HIV prevalence was nearly identical among current injectors (injected in the last 6 months) and heroin and cocaine users who had never injected: 13% [95% confidence interval (CI), 12-15%] among current injectors and 12% (95% CI, 9-16%) among never-injectors in the drug treatment program study, and 15% (95% CI, 11-19%) among current injectors and 17% (95% CI, 12-21%) among never injectors in the respondent driven sampling storefront study. The 95% CIs overlapped in all gender and race/ethnicity subgroup comparisons of HIV prevalence in both studies., Conclusions: The very large HIV epidemic among drug users in New York City appears to be entering a new phase, in which sexual transmission is of increasing importance. Additional prevention programs are needed to address this transition.

Objective: To assess trends in HIV, hepatitis C virus (HCV) and HIV/HCV infection among injecting drug users (IDU) from 1990 to 2001 in New York City. 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., Methods: Cross-sectional seroprevalence surveys of IDU entering drug abuse treatment in New York City, with sample sizes for HCV of 72 in 1990-1991 and 412 in 2000-2001. A structured risk behavior questionnaire was administered, and HIV and HCV testing were conducted. HCV testing was performed on de-linked stored serum samples., Results: Over the 1990-2001 period, HIV prevalence declined from 54 to 13%. HCV prevalence declined from 80 to 59% among HIV-seronegative individuals, and from 90 to 63% overall. The estimated HCV incidence in 2000-2001 among new injectors was 18 per 100 person-years at risk., Conclusions: The large-scale expansion of syringe exchange was temporally associated with large reductions in both HIV and HCV prevalence. The prevalence and incidence of HCV, however, still remain at high levels among IDU in New York City.