Enrollment of injection drug users (IDUs) into a peer-educator role in an HIV prevention intervention, especially in a small group, may help IDUs stop injecting, the current study suggests.
The authors conducted a secondary analysis of a multi-site randomized controlled HIV prevention intervention trial whose aim was to reduce sexual and injection drug use (IDU) risk behaviors among young IDUs. The secondary analysis examined the cessation or reduced frequency of IDU.
IDUs ages 15-30 who were antibody-negative for HIV and hepatitis C were randomized to a six-session, cognitive-behavioral skills-building intervention in which they learned peer education skills, or a time-equivalent attention control group. Follow-up interviews were conducted at three and six months after baseline. Participants reporting IDU in the previous three months at baseline, and at least one follow-up during which IDU was assessed, were eligible for the analysis (n=690).
Of participants, 27 percent reported at least one three-month period of IDU abstinence. The peer education intervention and smaller session size were significantly associated with injection cessation in a multivariate, zero-inflated negative binomial regression adjusting for prior injection frequency. Trial arm participation had no effect on frequency of injection among those who continued to inject.
"HIV prevention interventions that encourage [IDUs] to take on the role of peer educator may have the additional benefit of increasing the likelihood of injection cessation," the authors concluded. "Intervention group size is also an important consideration, with smaller groups having higher rates of cessation."
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