Objectives

This study evaluted a theory-based community-level intervention to promote progress toward consisten condom and bleach use among selected populations 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 patners, sex workers, non-gay-identified men who have sex with men, high-risk youth, and residents in areas with high sexually transmitted disease rates.

Iver a 3-year period, cross-seciontal interviews (n=15 205) wer 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-changes scores for condom and bleach use.

Conclusions

The intervention led to significant communitywide progress toward consistent HIV risk reduction.