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Richard J. Wolitski, PhD, and the Project START Writing Group for The Project START Study Group

Richard J. Wolitski is with the National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Ga.

Correspondence: Requests for reprints should be sent to Richard J. Wolitski, PhD, Prevention Research Branch, Divisions of HIV and AIDS Prevention, National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Rd NE (MS E–37), Atlanta, GA 30333 (e-mail: rwolitski{at}cdc.gov).

Objectives. We compared the effects of an enhanced multisession intervention with a single-session intervention on the sexual risk behavior of young men released from prison.

Methods. Young men, aged 18 to 29 years, were recruited from US prisons in 4 states and systematically assigned to the prerelease single-session intervention or the pre- and postrelease enhanced intervention. Both interventions addressed HIV, hepatitis, and other sexually transmitted infections; the enhanced intervention also addressed community reentry needs (e.g., housing, employment). Assessment data were collected before intervention, and 1, 12, and 24 weeks after release.

Results. A total of 522 men were included in intent-to-treat analyses. Follow-up rates ranged from 76% to 87%. Unprotected vaginal or anal sex during the 90 days before incarceration was reported by 86% of men in the enhanced intervention and 89% in the single-session intervention (OR=0.78; 95% CI=0.46, 1.32). At 24 weeks, 68% of men assigned to the enhanced intervention reported unprotected vaginal or anal sex compared with 78% of those assigned to the single-session intervention (OR=0.40; 95% CI=0.18, 0.88).

Conclusion. Project START demonstrated the efficacy of a sexual risk–reduction intervention that bridges incarceration and community reentry.