STRIVE is a group-level, clinic-based, behavioral intervention that aims to reduce risky distributive injection practices (e.g., syringe lending and unsafe drug preparation) among young injection drug users who are HCV positive. During six 2-hour sessions, two trained health advisors promote group cohesion and support peer education within the STRIVE group. The health advisors encourage behavior change by teaching peer-education tactics and risk reduction skills. The STRIVE program increases participants. HCV knowledge and risk awareness, problem-solving and risk-reduction skills, and supports sustained behavior change. The effectiveness of the STRIVE program was evaluated using a randomized trial design with a time-equivalent attention-control group. Participants included 418 HCV-positive injection drug users aged 18 to 35 years in three US cities. Participants reported their injection-related behaviors at baseline, and at three- and six-month follow-ups. Compared with the control group, intervention group participants reported a 26% relative reduction of distributive risk behaviors at three months and six months, but were no more likely to cite their HIV-positive status as a reason for refraining from syringe lending. Effects were strongest among intervention group participants who had known their HCV-positive status for at least six months. Peer mentoring and self-efficacy were significantly increased among intervention group participants, and intervention effects were mediated through self-efficacy. Click here to view more detailed information on this program.