Behavioural change in injecting drug users: Evaluation of an HIV/AIDS education programme

Martin, G; Serpelloni, Giovanni; Galvan, Umberto; Rizzetto, A; Gomma, M.; Morgante, Susanna; Rezza, Giovanni

doi:10.1080/09540129008257740

Cited by 35 publications

(10 citation statements)

References 9 publications

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“…duction in needle sharing. 5 The US General Accounting Office 48 reported on a study 50 that found that 9% of the injection drug users in methadone maintenance shared needles, whereas 48% of the injection drug users not in treatment shared needles, indicating an 81% reduction in needle sharing. We assumed that injection drug users in methadone maintenance inject 20% as often as injection drug users not in treatment (an 80% reduction in frequency) and share 30% as often as injection drug users not in treatment (a 70% reduction in sharing), leading to a 94% reduction in risky injections among injection drug users in methadone maintenance (20% × 30% = 6% as many risky injections).…”

Section: Methodsmentioning

confidence: 99%

“…We assumed that injection drug users not in treatment inject 200 times per year in the low-prevalence community and 225 times per year in the high-prevalence community [38][39][40][41][42][43][44] and that they share needles 20% of the time, 5,[40][41][42][43][45][46][47] leading to 40 and 45 risky injections per year, respectively, in the 2 communities.…”

Section: Methodsmentioning

confidence: 99%

“…2 Prevention programs for injection drug users may reduce HIV transmission by reducing risky behavior. [3][4][5][6][7] Substance abuse treatment, especially methadone maintenance, reduces risky behavior and consequent infection with HIV. [8][9][10][11][12][13][14][15][16][17][18] However, expansion of methadone maintenance programs or even the continuation of existing programs is controversial.…”

Section: Hiv Transmission and The Cost-effectiveness Of Methadone Maimentioning

confidence: 99%

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HIV transmission and the cost-effectiveness of methadone maintenance

Zaric¹,

Barnett²,

Brandeau³

2000

Am J Public Health

197

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OBJECTIVES: This study determined the cost-effectiveness of expanding methadone maintenance treatment for heroin addiction, particularly its effect on the HIV epidemic. METHODS: We developed a dynamic epidemic model to study the effects of increased methadone maintenance capacity on health care costs and survival, measured as quality-adjusted life-years (QALYs). We considered communities with HIV prevalence among injection drug users of 5% and 40%. RESULTS: Additional methadone maintenance capacity costs $8200 per QALY gained in the high-prevalence community and $10,900 per QALY gained in the low-prevalence community. More than half of the benefits are gained by individuals who do not inject drugs. Even if the benefits realized by treated and untreated injection drug users are ignored, methadone maintenance expansion costs between $14,100 and $15,200 per QALY gained. Additional capacity remains cost-effective even if it is twice as expensive and half as effective as current methadone maintenance slots. CONCLUSIONS: Expansion of methadone maintenance is cost-effective on the basis of commonly accepted criteria for medical interventions. Barriers to methadone maintenance deny injection drug users access to a cost-effective intervention that generates significant health benefits for the general population.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Hiv Transmission and The Cost-effectiveness Of Methadone Maimentioning

confidence: 99%

See 1 more Smart Citation

HIV transmission and the cost-effectiveness of methadone maintenance

Zaric¹,

Barnett²,

Brandeau³

2000

Am J Public Health

197

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“…Participants who adhered continuously to methadone treatment were less likely to share needles (18%) than were those who interrupted treatment (39%); after 1 year, the rate of syat North Dakota State University on June 25, 2015 http://cid.oxfordjournals.org/ Downloaded from ringe or needle sharing decreased from 35% to 12% [48]. With regard to HIV transmission, HIV seroconversion was ∼3.5% in IDUs who remained adherent to methadone maintenance treatment versus 22% in untreated patients after 1 year [36].…”

Section: Resultsmentioning

confidence: 86%

Adherence to Heroin Dependence Therapies and Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome Infection Rates among Drug Abusers

Castro

Sabaté

2003

CLIN INFECT DIS

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Adherence is a primary determinant of treatment effectiveness; thus, poor adherence attenuates optimum clinical benefit. A bibliographic review was conducted to evaluate the impact of adherence to heroin dependence treatment on human immunodeficiency virus (HIV) transmission and to identify interventions proven to be effective in improving adherence. The best adherence rates were achieved by methadone and diacetylmorphine, both of which are comparable in promoting significant reduction in heroin use. Methadone adjusted-dose studies with daily doses ranging from 100 to 200 mg and multiple support interventions achieved the highest adherence rates. Studies of methadone maintenance that examined changes in HIV prevalence of infection have found that higher treatment adherence is correlated with a reduction in HIV transmission. These data suggest that patients who adhere continuously to methadone treatment are less likely to continue injecting illicit drugs and sharing contaminated injection equipment than are those who interrupt treatment, thus preventing the spread of HIV via drug injection.

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“…Donoghoe et al, 1989;Mulleady et al, 1990) very little research has been published to date on attempts to change the sexual behaviour of this client group. In Italy, following educational and counselling interventions with drug users, both Martin et al (1990) and Nicolisi et al (1991) concluded that sexual behaviour was more difficult to change than drug-using behaviour. In America Schilling et al (1 99 1) undertook a skills-building intervention for female methodone patients which provided only modest moderation of sexual risk behaviour.…”

Section: Introductionmentioning

confidence: 97%

Evaluation of a training course on sexual counselling in a drug work setting

et al. 1994

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It has been repeatedly reported that while risks associated with the injecting behaviour of drug users has been reduced, no parallel changes have been made in sexual risk behaviour. Counselling advice to clients attending drug unit services has not focused sufficiently on the sexual behaviour of this client group. The present study evaluates the impact of a 4-day tailored training course on the counselling practices of two teams of drug workers at a London hospital. The course was designed following the experience and evaluation of a more general training course on sexual issues, and included information, group discussions, experiential learning and skills training. Results indicate that though there were no significant behavioural changes, some attitudinal changes have taken place; training appears to have increased the staff's awareness of the importance of sexual counselling and reduced the perceived difficulty of discussing certain specific sexual issues. The implications of single-agency training courses are discussed and recommendations are made for future training courses on the basis of the findings of this study.

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Behavioural change in injecting drug users: Evaluation of an HIV/AIDS education programme

Cited by 35 publications

References 9 publications

HIV transmission and the cost-effectiveness of methadone maintenance

HIV transmission and the cost-effectiveness of methadone maintenance

Adherence to Heroin Dependence Therapies and Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome Infection Rates among Drug Abusers

Evaluation of a training course on sexual counselling in a drug work setting

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