A peer-education intervention to reduce injection risk behaviors for HIV and hepatitis C virus infection in young injection drug users

• Published in: AIDS (London) Vol. 21; no. 14; pp. 1923 - 1932
• Main Authors: GARFEIN, Richard S, GOLUB, Elizabeth T, STRATHDEE, Steffanie A, THIEDE, Hanne, GREENBERG, Alan E, HAGAN, Holly, HANSON, Debra L, HUDSON, Sharon M, KAPADIA, Farzana, LATKA, Mary H, OUELLET, Lawrence J, PURCELL, David W
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 12.09.2007
• Subjects: Adolescent; Adolescent Behavior - psychology; Adult; Behavior Therapy - methods; Biological and medical sciences; Drug addictions; Female; Health Education - methods; Hepatitis C - epidemiology; Hepatitis C - prevention & control; Hepatitis C virus; HIV Infections - epidemiology; HIV Infections - prevention & control; Human immunodeficiency virus; Human viral diseases; Humans; Incidence; Infectious diseases; Male; Medical sciences; Peer Group; Risk Reduction Behavior; Sexual Behavior - psychology; Substance Abuse, Intravenous - epidemiology; Substance Abuse, Intravenous - psychology; Toxicology; Treatment Outcome; United States - epidemiology; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Viral hepatitis; United States; North America; America; USA; Intravenous administration; Hepatic disease; Epidemiology; Incidence; Education; Behavior; Viral hepatitis C; injection drug use; Human; Immunopathology; Drug addiction; AIDS; peer education; Immune deficiency; randomized controlled trial; Infection; Virus; HIV; Viral disease; Young adult; Risk factor; Digestive diseases; Flaviviridae; Hepatitis C virus; Hepacivirus; Arm
• DOI: 10.1097/QAD.0b013e32823f9066
• ISSN: 0269-9370

To evaluate whether a behavioral intervention, which taught peer education skills, could reduce injection and sexual risk behaviors associated with primary HIV and hepatitis C virus infection (HCV) among young injection drug users (IDU). We conducted a randomized controlled trial involving HIV and HCV antibody-negative IDU, aged 15-30 years, recruited in five United States cities. A six-session, small-group, cognitive behavioral, skills-building intervention in which participants were taught peer education skills (n = 431) was compared with a time-equivalent attention control (n = 423). Baseline visits included interviews for sociodemographic, psychosocial, and behavioral factors during the previous 3 months; HIV and HCV antibody testing; and pre/posttest counselling. Procedures were repeated 3 and 6 months postintervention. The intervention produced a 29% greater decline in overall injection risk 6 months postintervention relative to the control [proportional odds ratio 0.71; 95% confidence limit (CL) 0.52, 0.97], and a 76% decrease compared with baseline. Decreases were also observed for sexual risk behaviors, but they did not differ by trial arm. Overall HCV infection incidence (18.4/100 person-years) did not differ significantly across trial arms (relative risk 1.15; 95% CL 0.72, 1.82). No HIV seroconversions were observed. Interventions providing information, enhancing risk-reduction skills, and motivating behavior change through peer education training can reduce injection risk behaviors, although risk elimination might be necessary to prevent HCV transmission.