Using Stages of Change to Assess Intervention Readiness and Outcome in Modifying Drug-Related and Sexual HIV Risk Behaviors of IDUs and Crack Users

SUMMARY This paper examines the utility of the stages-of-change model in assessing intervention readiness and measuring the outcome of targeted interventions in modifying eight drug-related and sexual risk behaviors of active drug users. Injection drug and crack cocaine users (N = 560) recruited through street outreach were administered questionnaires measuring intentions, behaviors, and beliefs pertaining to eight drug-related and sexual strategies for reducing personal HIV risk at the time of their enrollment in an HIV risk intervention program. Six-month follow-up data were available for 205 of the 325 individuals who were eligible for follow-up. At baseline, a large percentage of injectors were in the action or maintenance stage with regard to safe injection practices. Men were significantly higher than women in stage of change for not sharing needles. Very few individuals were using condoms with their main partner, but the percentage was much higher with casual partners, especially among sex workers. Follow-up data indicated a general shift toward higher stages for all behaviors, with changes in both intentional and behavioral stages. Differences between initial and final stage of change were statistically significant for all target behaviors except condom use with main partner.