Coordinated education and counseling services can successfully control at-risk behaviors such as needle-sharing among injection drug users and thereby curb the spread of HIV and hepatitis C among this high-risk population, a new study has confirmed.
Published in the April issue of the journal AIDS Education and Prevention (2014;26:144-157), the study assessed the efficacy of the “Staying Safe Intervention,” which was developed by researchers at New York University’s (NYU) Center for Drug Use and HIV Research, in New York City. The program’s content was based on the findings of an earlier study that observed the behaviors of injection drug users and the stigmas associated with these behaviors. Participants in this earlier study injected drugs for as long as 15 years without contracting HIV or hepatitis C, due in part to self-imposed safeguards. These safeguards served as the underpinnings of the strategies at the core of the Staying Safe Intervention.
For the new study, injection-drug users were enrolled in the 5-session Staying Safe education program, which included material on safe injection strategies, the risks for HIV and hepatitis C associated with injection drug use, and approaches for managing these risks. In all, 68 injection drug users participated in the intervention, and 87% attended at least 1 group session; 46% of study participants attended all 5.
According to the study authors, participants reported increases in planning skills to avoid injection-related risks (P<0.001), increases in self-efficacy in avoiding sharing injection equipment (P=0.005), and increases in stigma management strategies (P=0.002). At 3-month follow-up, patients reported that their average weekly injections and daily drug expenses declined (P<0.001), and that their mean daily drug expenditure dropped from $77 before the Staying Safe Intervention to $47 after. Additionally, there were reductions in overall sharing of syringe and nonsyringe injection equipment, cotton filters, water, and water containers when diluting drugs (P<0.001 for all) among study participants.
“Given the substantial reductions observed among Staying Safe participants in key injection-related behaviors associated with HCV transmission, the Staying Safe Intervention may have the potential to contribute to sufficient additional risk reduction to help address the seemingly intractable rates of HCV transmission among people who inject drugs,” the study’s principal investigator, Pedro Mateu-Gelabert, PhD, said in a statement on the study released by NYU. “The goal is to implement the Staying Safe approach with this new generation of young injectors, so they do not get infected with HIV or HCV.”