Effective Interventions

Effective Interventions

High Impact Prevention

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.

Safety CountsThis 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.

Important CDC Update: 

The CDC’s strategy for High Impact HIV Prevention involves prioritizing and implementing an optimal combination of cost-effective, scalable interventions based on the current state of the science.  This shift should help improve the effectiveness of HIV prevention efforts, reduce HIV incidence, and ultimately increase the possibility of achieving an AIDS-free America.  In its ongoing effort to align HIV prevention resources with current surveillance data and this strategy, the Division of HIV/AIDS Prevention (DHAP) at CDC will not offer trainings or capacity building assistance on the following evidence-based interventions (EBIs): AIM, ¡Cuídate!, Focus on Youth, MIP, Nia, RAPP, Safety Counts, SHIELD, SIHLE, SISTA, Street Smart, RESPECT and VOICES/VOCES (except when used with MSM). The Division also will not offer trainings or capacity building assistance on some new EBIs, such as Healthy Love. Health departments or other funders may continue to support implementation of these EBIs, and the implementation materials for all these interventions will remain on this site and be available for download. If you have additional questions about this issue, please contact interventions@danya.com.

CDC’s Division of Reproductive Health (DRH) will provide support to their grantees on AIM, ¡Cuídate!, and SIHLE. For further information on DRH’s efforts, please contact Trisha Mueller at czj5@cdc.gov

How to request Safety Counts training and technical assistance

As listed above, CDC no longer offers training or capacity building for Safety Counts. If Safety Counts training is desired, contact any of the Safety Counts trainers within the following organizations listed below to make individual arrangements to obtain training. You are welcome also contact the original researchers. All costs associated with receiving Safety Counts training will be paid by the requesting agency or individual. Here's a printer friendly version of the Safety Counts Master Trainer List

JSI Research & Training Institute, Inc.
Juli Powers, MPH
437 Memorial Dr. SE., Suite A11
Atlanta, GA 30312
Direct: (404) 460-4794
Email: jpowers@jsi.com
Website: www.cba.jsi.com

Sarahjane Rath, MPH, CHES
Capacity Building Coordinator
Email: srath@proceedinc.com

Gisele Pemberton, DrPH, MPH, CHES
Director, National Center for Training, Support and Technical Assistance
Email: gpemberton@proceedinc.com

1126 Dickinson Street
Elizabeth, NJ 07201
Main: (908) 351-7727
Website: www.proceedinc.com

Harm Reduction Coalition (HRC)
Michael T. Everett, MHS
Team Lead Capacity Building Advisor for CBOs
22 West 27th Street, 5th Floor
New York, NY 10001
Direct: (212) 213-6376 ext. 36
Main: (212) 213-6376
Email: everett@harmreduction.org
Website: www.harmreduction.org

Latino Commission on AIDS
Leandro Rodriguez
24 West 25th Street, 9th Floor
New York, NY 10010
Main: (212) 675-3288
Email: lrodriguez@latinoaids.org
Website: www.latinoaids.org

AIDS Project Los Angeles (APLA)
Jordan Blaza
CBA Specialist
3550 Wilshire Blvd., Suite 300
Los Angeles, CA 90010
Direct (213) 201-1443
Main: (213) 201-1600
Email: jblaza@apla.org
Website: www.apla.org

To learn more about research, contact:
Jonny Andia, PhD
Centers for Disease Control and Prevention
Direct: (404) 639-4956
Email: efn4@cdc.gov

Research and Development for Safety Counts

Rotheram-Borus, MJ., Rhodes, F., Desmond, K., Weiss, RE. (2010). Reducing HIV risks among active injection drug and crack users: the safety counts program. AIDS and Behavior, 14(3):658-68. Epub 2009 Sept. 11.

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 need to 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.

More Info

Safety Counts Core Elements

  • Group Session One and Group Session Two (identify client’s HIV risks and current stage of change, hear risk-reduction success stories, set personal goal, identify first step to reduce HIV risk, and make referrals to C&T and medical/social services)
  • One (or more) Individual Counseling Session (discuss/refine risk-reduction goal, assess client’s needs, and provide needed referrals to C&T and medical/social services)
  • Two (or more) Social Events (share meal and socialize, participate in a planned HIV-related risk-reduction activity, and receive reinforcement for personal risk reduction)
  • Two (or more) Follow-up Contacts (review client’s progress in achieving risk-reduction goal, discuss barriers encountered, identify concrete next step and discuss possible barriers/solution, and make referrals to C&T and medical/social services)
  • HIV/HCV Counseling and Testing (offer the client this service either through referrals or at the implementing agency)

The materials on this site are designed for HIV/AIDS prevention with persons at risk for acquiring or transmitting HIV. They are meant to be resources used by HIV prevention providers such as health departments and community-based organizations so as to provide the best evidence-based HIV prevention services. These materials are not meant for the general public. They are not meant for children. They are not school-based HIV prevention strategies.