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Safety Counts is an HIV prevention intervention for out-of-treatment active injection and non-injection drug users aimed at reducing both high-risk drug use and sexual behaviors. It is a behaviorally focused, seven-session intervention, which includes both structured and unstructured psycho-educational activities in group and individual settings.

This intervention works well with CDC's Advancing HIV Prevention initiative as it strongly encourages HIV testing as a precursor to program enrollment, clients can be recruited from testing programs, and sessions include a discussion of the importance of testing to the client. The intervention addresses the needs of both HIV-negative and HIV-positive clients.

New Recruitment and Retention Module for Safety Counts Trainings

The training on the Safety Counts intervention has a new module devoted to recruitment and retention issues. The module provides participants with information and strategies to effectively recruit and retain appropriate individuals in Safety Counts. Two main recruitment strategies are discussed - Targeted Recruitment and Peer Driven Recruitment (based on the Respondent-Driven Sampling method). In studies, the peer driven recruitment strategy has been found to be particularly useful in recruiting hard-to-reach populations and a relatively large number of participants within a short time frame. The module also includes strategies on developing an effective retention plan. Highly specialized trainers use small group activities, handouts, and interactive discussion to build participants' skills in this critical aspect of intervention implementation. A complete module in Spanish plus a fully bilingual training are available through trainers at CDC - funded national Capacity Building Assistance (CBA) provider agencies.

There are three ways to obtain the new Recruitment and Retention training:

• (Available now) During a regular Safety Counts training - A third day of training has been added to the original Safety Counts training so the recruitment and retention module can be presented. Apply for training here
• (Available now) One day face-to-face training provided by CBA Safety Counts trainers - Technical Assistance must be requested through the CDC's CBA Request Information System (CRIS) - www.cdc.gov/hiv/topics/cba/index.htm
• (Coming soon) Online training provided by CBA Safety Counts trainers - Health Departments and CDC directly-funded agencies must request this method of technical assistance through CRIS - www.cdc.gov/hiv/topics/cba/index.htm

Appropriate Participants for the Safety Counts Training

We strongly recommend that two staff from each agency planning to implement the intervention attend a Safety Counts training and their selection follow these requirements:

• The Counselor (or other staff person) who will have primary responsibility for conducting the Safety Counts group and individual sessions.
• The Executive Director or Program Manager who will oversee the intervention to facilitate agency internal capacity building and commitment to Safety Counts.

Research and Development

Hershberger, S. L., Wood, M. M., Fisher, D. G. (2003). A cognitive-behavioral intervention to reduce HIV risk behaviors in crack and injection drug users. AIDS and Behavior, 7, 229-243.

Rhodes, F., Wood, M.M., & Hershberger, S.L. (2000). A cognitive-behavioral intervention to reduce HIV risks among active drug users: Efficacy study. In Staying negative in a positive world: HIV prevention strategies that work (pp. 113-124). Sacramento: California Department of Health Services, Office of AIDS.

Rhodes, F., & Malotte, C.K. (1996). HIV risk interventions for active drug users: Experience and prospects. In S. Oskamp & S. C. Thompson (Eds.), Understanding and preventing HIV risk behavior: Safer sex and drug use (pp. 207-236). Thousand Oaks, CA: Sage Publications.

Rhodes, F., & Wood, M.M. (2000). A cognitive-behavioral intervention to reduce HIV risks among active drug users. In Staying negative in a positive world: HIV prevention strategies that work (pp. 97-111). Sacramento: California Department of Health Services, Office of AIDS.

Wood, M.M., & Rhodes, F. (2000). A cognitive-behavioral intervention to reduce HIV risks among active drug users: Implementation issues. In Staying negative in a positive world: HIV prevention strategies that work (pp. 125-144). Sacramento: California Department of Health Services, Office of AIDS.

Rhodes, F., Wood, M.S. (1999). A cognitive-behavioral intervention to reduce HIV risks among active drug users. Paper presented at the 127th Annual Meeting of the American Public Health Association, Chicago, IL.

Rhodes, F., Humfleet, G.L. (1993). Using goal-oriented counseling and peer support to reduce HIV/AIDS risk among drug users not in treatment. Drugs & Society (3/4):185-204.

Program Review Panel Information

The CDC requires all CDC-funded agencies using the Safety Counts intervention to identify, or establish, and utilize a Program Review Panel and complete Form 0.1113 to document this activity. The intervention researchers and developers are not involved in this activity. This is a CDC requirement for their grantees, and all questions in this regard should be directed to your agency's CDC Project Officer or to the health department funding your agency's implementation of the intervention.

The Program Review Panel guidelines, instructions for completion of Form 0.113, and the form itself are available under the Related Links section of this web site.

CDC Policy on Youth Peer Outreach Workers

CDC funded (directly or indirectly) agencies using youth (either paid or volunteer) in program outreach activities, it is very important that said organizations use caution and judgment in the venues/situations where youth workers are placed. Agencies should give careful consideration to the "age appropriateness" of the activity or venue. Additionally, agencies should comply with all relevant laws and regulations regarding entrance into adult establishments/environments. Laws and curfews should be clearly outlined in required safety protocols developed and implemented by agencies directly and indirectly funded by CDC.

If you have specific questions, please contact your CDC project officer.