Couple-Based HIV Prevention for Injecting Drug Users in Kazakhstan: A Pilot Intervention Study

Abstract

This pilot randomized controlled trial in Kazakhstan aimed to adapt and test the feasibility of a couple-based HIV/STI risk-reduction intervention (CHSR) for couples who are injecting drug users (IDUs). The study examined the preliminary effects of the intervention versus an attentional control wellness promotion (WP) condition on HIV risk behavioral outcomes among 40 couples who are IDUs (n = 80 participants). Compared with WP participants, CHSR participants were significantly more likely to increase condom use and decrease unsafe injection acts at the 3-month follow-up. This pilot trial demonstrates the feasibility and preliminary effects of the CHSR in reducing drug-related and sexual HIV risks.

Preventing blood-borne virus infection in people who inject drugs in the UK: systematic review, stakeholder interviews, psychosocial intervention development and feasibility randomised controlled trial

“…'Contingent vouchers were given when a participant provided a cocainenegative urine specimen'); 71 training (imparting skills, e.g. 'intervention included psychosocial training and skills building to teach personal risk reduction and negotiation skills' 72 and 'technical condom use and syringe disinfection skills'); 73 modelling (providing an example for people to aspire to or imitate, e.g. 'model injection and sexual risk reduction behaviors with their risk network members' 74 and 'demonstration and rehearsal of syringe cleaning and condom application'); 70 and enablement (increasing means/reducing barriers, e.g.…”

“…Twenty-four trials were included in the meta-analysis. 22,[68][69][70][71][72][73]75,76,81,82,173,175,179,180,182,186,188,189,[192][193][194][195]197 The reasons for excluding eight trials from the meta-analysis were not providing the number of PWID for control and intervention groups at follow-up, 84,174,176,177,196 only providing risk ratios, 178 outcome combined HIV infections with sexually transmitted infections 77 and data for 'unsafe injection practices' were presented only at baseline. 74 …”

“…69,72,74,76,179,180,182,190 The majority of interventions contained at least three sessions (n = 25), 22,[69][70][71][72][73][74]76,81,82,173,174,[176][177][178][179][180]182,186,188,190,[192][193][194]196,197 four interventions contained two sessions, 68,75,187,195 and three interventions contained only one session. 77,175,197 Most interventions were delivered in drug treatment settings, including outpatient and hospital clinics, 71,72,173,[192][193][194] methadone maintenance clinics, 174,…”

“…In total, 12,840 participants (35% female, range 0-100%) were enrolled in the trials; the majority were PWID (84.5%) (the proportion of participants enrolled in the trials who were PWID ranged from 16% to 100%). The majority (n = 18) of trials were conducted in the USA, 22,68,[70][71][72]76,81,84,174,176,177,179,182,186,189,193,195,196 three were conducted in Russia, 74,75,194 two were conducted in Canada, 175,178 two were conducted in Vietnam, 82,180 one was conducted in Kazakhstan, 73 one was conducted in Georgia, 188 one was conducted in Australia, 197 one was conducted in the UK, 173 one was conducted in Mexico, 77 one was conducted in Puerto Rico 192 and one was conducted in both the USA and Thailand. 69 Trials included in the systematic review compared psychosocial interventions with usual care (n = 4), 22,68,178,195 education or information (n = 9), 70,76,77,175,176,180,188,…”

“…84,177 The remaining eight trials delivered interventions in more than one way (e.g. individual and couples sessions, 187,188 individual and group sessions, 69,76,186,190,194 Records identified from electronic database searches ( Samet 2015 194 Rotheram-Borus 2010 193 Robles 2004 192 Purcell 2007 189 Otiashvili 2012 188 McMahon 2013 84 Margolin 2003 Hoffman 2013 74 Go 2015 82 Go 2013 180 Gilbert 2010 73 Garfein 2007 179 Gagnon 2010 178 El-Bassell 2011 177 Dushay 2001 ) and one trial provided both individual-and structural-level activities. 82 For interventions with more than one session, retention or adherence to the intervention ranged from 50% 68 to 95%.…”