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doi: 10.1097/QAD.0b013e32823f9066
Epidemiology and Social

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

Garfein, Richard Sa,g; Golub, Elizabeth Tb; Greenberg, Alan Ea,i; Hagan, Hollyc; Hanson, Debra La; Hudson, Sharon Md; Kapadia, Farzanae; Latka, Mary He; Ouellet, Lawrence Jf; Purcell, David Wa; Strathdee, Steffanie Ag; Thiede, Hanneh; for the DUIT Study Team

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Objectives: 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).

Design: 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.

Results: 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.

Conclusion: 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.

© 2007 Lippincott Williams & Wilkins, Inc.


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