A randomized intervention trial to reduce the lending of used injection equipment among injection drug users infected with hepatitis C

Division of International Health and Cross Cultural Medicine, University of California School of Medicine, 9500 Gilman Dr, Mailstop 0622, La Jolla, CA 92093, USA.
American Journal of Public Health (Impact Factor: 4.23). 06/2008; 98(5):853-61. DOI: 10.2105/AJPH.2007.113415
Source: PubMed

ABSTRACT We evaluated the efficacy of a peer-mentoring behavioral intervention designed to reduce risky distributive injection practices (e.g., syringe lending, unsafe drug preparation) among injection drug users with hepatitis C virus (HCV) infection.
A randomized trial with a time-equivalent attention-control group was conducted among 418 HCV-positive injection drug users aged 18 to 35 years in 3 US cities. Participants reported their injection-related behaviors at baseline and at 3- and 6-month follow-ups.
Compared with the control group, intervention-group participants were less likely to report distributive risk behaviors at 3 months (odds ratio [OR]=0.46; 95% confidence interval [CI]=0.27, 0.79) and 6 months (OR=0.51; 95% CI=0.31, 0.83), a 26% relative risk reduction, but were no more likely to cite their HCV-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 6 months. Peer mentoring and self-efficacy were significantly increased among intervention-group participants, and intervention effects were mediated through improved self-efficacy.
This behavioral intervention reduced unsafe injection practices that may propagate HCV among injection drug users.

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Available from: Richard S Garfein, Aug 17, 2015
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    • "In lieu of SEPs, behavioral and clinical interventions may be applicable. Peer-driven and other behavioral interventions could also be considered as a way to reduce HCV risk behavior in this population [Garfein et al., 2007; Latka et al., 2008; Sacks-Davis et al., 2011]. Programs and funding to improve residents' access to health care and to drug treatment also could help to prevent and/or mitigate the long-term consequences of HCV infection. "
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    • "Gaining HCV vaccine trial and prevention knowledge may generate benefits that are twofold; it may serve to directly increase individual knowledge as well as providing an opportunity for PWID to accomplish altruistic goals of communicating knowledge within their social networks, which, in turn, may increase the value of trial participation for individual PWID. Peer-driven interventions are increasingly important and have been shown to be effective in reducing injection risk behaviours among HCV negative (Garfein et al., 2007; Mackesy-Amiti et al., 2011), HCV positive (Latka et al., 2008) and mixed (Tobin et al., 2011) populations of PWID, and may optimise prevention efforts in future vaccine trials. "
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