Interventions that incorporate education of injection drug users regarding safe injection practices and sexual risk reduction are critical to prevention. Information and education can be provided through a number of avenues, including general awareness campaigns, though it can also be more focused and directed dissemination of information through the health and social services frequented by injection drug users. Education campaigns often utilize peer and drug-user networks and outreach workers (Ball et al, 1998). Of key importance is easy access HIV testing, which is typically accompanied by risk-reduction counseling involving face-to-face communication. Finally, secondary prevention for individuals already infected with HIV or hepatitis is also critical. Providing access to primary care and antiretroviral treatment programs may facilitate behavior change and prevent further transmission. Comprehensive strategies are the key to effective prevention. For example, it is imperative that safe injection messages be complemented with safesex messages and condom promotion. In the case of MMT programs, for example, the effect on reduction in injection-related risk behavior is consistent; however, the evidence of its effect on sexual risk behavior is controversial. Although MMT offers an opportunity for comprehensive HIV prevention, many programs do not offer sexual risk-reduction counseling (Sorensen and Copeland, 2000).

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