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The NIDA Community-Based Outreach Model:
A Manual To Reduce the Risk of HIV and Other Blood-Borne Infections in Drug Users

The NIDA Community-Based Outreach Model

The NIDA Community-Based Outreach Model (the NIDA Outreach Model) is based on more than 15 years of NIDA-funded research. The model has been implemented and tested in 52 communities with more than 60,000 injection drug users (IDUs) and many of their sex partners. It has also been adapted and tested with nearly 14,000 crack users and tailored to the needs of specific at-risk subgroups, including women who inject drugs, men who use drugs and have sex with men, and drug and sexual risk networks. Overall, community-based outreach for HIV risk reduction has been found to be effective with multiracial, multi-ethnic, male and female, HIV seropositive, and seronegative drug-using populations residing in areas with low, medium, and high HIV prevalence.

The NIDA Outreach Model is readily adaptable to changing patterns of drug use and HIV risk behaviors in drug-using populations and local communities. Over time, the model has evolved to incorporate new knowledge about drug use, risk behaviors, and the prevention of HIV and other blood-borne diseases (e.g., hepatitis B [HBV] and hepatitis C [HCV]) and new techniques for HIV risk and serostatus assessment. The model includes two interrelated components designed to facilitate behavior change among at-risk drug users:

  • Community-based outreach conducted in a range of local settings to access and engage drug users in the process of behavior change to prevent HIV and other blood-borne infections; and

  • Two education and risk reduction sessions organized around HIV, HBV, and HCV testing to provide pre- and post-test counseling to help drug users learn about their serostatus and the behavior changes needed to reduce transmission risks.

Community-based outreach...

  • relies on outreach workers who typically are indigenous to the local community, familiar with the drug use subculture, and trusted as a source of information. Outreach workers are uniquely able to serve as role models, educators, and advocates who can provide drug users with changing and accurate risk reduction information in settings that are familiar to them and at times of greatest risk.

  • is an effective strategy for providing at-risk populations with the means for behavior change (e.g., HIV/AIDS educational materials, bleach kits for disinfecting injection equipment, and condoms for safer sex) to reduce or eliminate their HIV/AIDS transmission risk. It Is also effective in providing drug users with referrals for HIV testing and counseling, drug treatment, and other health services.

  • is a low-cost intervention approach that permits ongoing contact with drug users and multiple opportunities to reinforce the HIV risk reduction message.

HIV pre-/post-test education and risk reduction counseling...

  • complement the role of community-based outreach workers by repeating the hierarchical sets of drug- and sex-related risk reduction messages at each contact, by providing the means for behavior change, and by making referrals to drug treatment and other health services.

  • offer opportunities to drug users to learn their serostatus for HIV, HBV, and HCV; assess and understand their personal risk; and acquire new information and skills to reduce infection risks and prevent transmission to others.

  • enable seropositive persons to inform their drug and sex partners about potential risk of infection and the importance of getting tested and counseled for HIV and other blood-borne infections.


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