Eur. J. Epidemiol. 0392-2990 March 1992, p. 264-267 EUROPEAN JOURNAL OF EPIDEMIOLOGY Vol. 8, No. 2 SUSTAINED AIDS EDUCATION CAMPAIGNS AND BEHAVIOURAL CHANGES IN ITALIAN DRUG ABUSERS F. BORTOLOTTI 1, A. STIVANELLO, F. NOVENTA, G. FORZA, N. PAVANELLO and A. BERTOLINI Clinica Medica 2 - Universit~ di Padova - Via GiustinianL 2 - 35100 Padova - Italy. Key words: AIDS - AIDS education campaigns - Drug abusers - HIV infection Risk behaviours for HIV infection In the area of Padua, northern Italy, fear of AIDS along with AIDS educational campaigns had reduced risk behaviours for HIV among intravenous drug abusers (WDA) as early as 1987, although at that time 38% of seropositive cases still shared needles and only 22% of subjects used condoms. The present study has been conducted in the same area and with similar criteria to evaluate the effectiveness and limits of a sustained education campaign. Drug related and sexual risk behaviours and motivations preventing behavioural changes were investigated by direct interview in 190 IVDA. Fourteen percent of the participants, including 16% of the seropositive, were still sharing needles, mainly because they did not have works available at the time they were needed. Demographic features, drug-related characteristics and anti-H1V seroprevalence did not differ significantly between needlesharers and other drug abusers. Condom use was reported by 46% of subjects, but encouragingly enough this figure included 80% of the seropositives. While knowledge of seropositivity seemed to encourage condom use, a higher selectivity about partners and a negative attitute towards condoms were the most frequent motivations preventing safer sex. These results suggest that sustained AIDS education campaigns are being successful in maintaining and reinforcing the trend to risk reduction previously observed among drug abusers in this area. Nevertheless the persistence of risk behaviours in a consistent proportion of participants emphasizes the urgency of additional prevention strategies, such as syringe exchange or supply to the limited number of sharers and counselling to encourage safer sex. INTRODUCTION Intravenous drug abusers (1VDA) represent the largest reservoir of infection with human immunodeficiency virus (HIV) in Italy and are one of the most likely vectors of HIV transmission to the general community through heterosexual contact and perinatal transmission (6, 8, 9). Control of HIV spread within this group is based on inducing individual risk reduction through education, counselling, syringe exchange and supply, free access to condoms or methadone maintenance. Corresponding author. In this area a sustained AIDS information and education campaign, particularly focused on drug- related risk behaviours has been conducted during the past 5 years in the absence of other specific preventive measures. The effects of such a campaign were already evident in 1987, when we performed a preliminary investigation in a sample of 185 long-term IVDA (2). In fact, participants reported a significant reduction of needlesharing and a significant increase in condom use. Nevertheless, 38% of seropositive addicts still engaged in needlesharing and, overall, only a minority used condoms. The present study has been undertaken to evaluate whether, over a longer time span, information and education campaigns could 264