By Ethan Covey
Community harm reduction programs can have a significant impact on behaviors linked to HIV and drug use among residents of communities on the borders of the United States and Mexico, according to data presented during AIDS 2024, in Munich (abstract OAC1002).
The intervention—Project Encuentro—focused on El Paso, Texas, and Ciudad Juárez, Mexico.
“There is a visible amount of disparity between the two cities, even though there is only a separation of about 50 yards,” said Gilberto Perez, MPH, a graduate research assistant at Hunter College and Latinx doctoral student in health psychology at the Graduate Center, City University of New York, in New York City.
“Border cities are transshipment corridors for drugs and are well-known destinations for drug use and sex tourism,” Mr. Perez added. “In Ciudad Juárez, drug usage rates are three times the Mexican national average, males residing on the U.S.-Mexico border frequently cross the border for sex, and female sex workers in Ciudad Juárez have an HIV prevalence rate of 8%.”
The aim of the study was to adapt, implement and test the effectiveness of a multilevel community HIV risk reduction behavioral intervention.
The intervention consisted of multiple components, including:
- increasing rapid HIV testing rates;
- reducing risk behaviors in social networks; and
- targeting structural factors affecting and harming the lives of people who use drugs.
Each of the components was developed to ameliorate the negative influence of factors operating at the structural, interpersonal and individual levels.
A total of 355 people who use drugs were recruited to participate in the intervention.
The study findings, which were focused on the period pre- and post-implementation of the risk reduction intervention, showed the effectiveness of the program in the number of condom-less sex acts in the last 30 days, safe injection practices (how many of six actions did they take in the last 30 days) and how many preventive measures from a nine-item list did they take in the past 30 days
A significant drop in condomless sex acts was reported from 65.04 before the program was implemented to 29.04 after it was implemented; as was an increase in safe injection practices from 2.5 before to 3.6 afterward; and an increase in the adaptation of preventive behaviors from 2.4 to 4.06.
Future research may elucidate which intervention components or combination of components is most effective, especially if resources are constrained.
In addition, Perez noted that better assessing the effectiveness of peer-based interventions may be helpful.
“It’s not widely researched, and I think it’s a very important framework to utilize moving forward interventions in marginalized communities that are trying to access individuals who use drugs and include them throughout the whole spectrum of research design and implementation,” he said.
The sources reported no relevant financial disclosures.
