Targeting HIV-related outcomes with intravenous drug users maintained on methadone: A randomized clinical trial of a harm reduction group therapy

Avants, S. Kelly; Margolin, Arthur; Usubiaga, Mary Helen; Doebrick, Cheryl

doi:10.1016/s0740-5472(03)00159-4

Cited by 97 publications

(104 citation statements)

References 49 publications

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“…Reducing unsafe injection practices among IDUs has been the target of numerous interventions designed to reduce the transmission of HIV and HCV (e.g., Avants et al 2004;Garfein et al 2006; National Institute on Drug Abuse 2000; Sterk et al 2003;Strathdee et al 2006). Our findings support the theory that receptive syringe sharing among young female IDUs is associated with both intrapersonal characteristics and characteristics of the social environment, and that the influence of sexual partners plays an important role.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Intimate Partner Violence on Receptive Syringe Sharing Among Young Female Injection Drug Users: An Analysis of Mediation Effects

et al. 2007

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This study sought to explore the relationship between intimate partner violence (IPV) and receptive syringe sharing (RSS) among young female injection drug users (IDUs) and to examine mediating variables. Cross-sectional behavioral assessments were completed by 797 female IDUs in five U.S. cities who reported having at least one main sexual partner in the past three months. Linear regression was used to estimate direct and mediated effects. The product of coefficients method was used to statistically evaluate mediation. Respondents were predominantly white (70%) and mean age was 23 years. Sixty percent reported RSS in the past three months and 33% reported IPV in the past year. The association between IPV and RSS was independently mediated by self-esteem and depression, but not by self-efficacy for safer drug injection. Findings suggest that interventions focused on improving victimized women's self-esteem and depression may help mitigate some of the negative health effects of IPV.

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Section: Discussionmentioning

confidence: 99%

The Effect of Intimate Partner Violence on Receptive Syringe Sharing Among Young Female Injection Drug Users: An Analysis of Mediation Effects

et al. 2007

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“…It is also unlikely that external influences led to changes we detected in what are well established as difficult-to-change behaviors. 32 In addition, because of the community-based clinical context in which the present study was conducted, we were obliged to use a brief assessment battery 29 that covered a relatively short time frame 3 and did not capture long-term behavioral patterns. Related to this, we should emphasize that our objective was to optimize the CHRP intervention within community-based treatment programs where significant rates of continued drug-and sex-related HIV risk behavior have been well documented 3,4,26,33 and where intervention integration appears promising 26 ; our findings are not intended to generalize to Bout-of-treatment^IDUs who may tend to possess different characteristics (e.g., pre-contemplation stage of health behavior change 34 ) that may be more effectively addressed using a different intervention approach.…”

Section: Discussionmentioning

confidence: 99%

“…The intervention from which our study data were obtained was the Community-friendly Health Recovery Program (CHRP), 26 which is an adapted, substantially abbreviated, form of the comprehensive evidence-based Holistic Health Recovery Program (HHRP). 3,4,27 The CHRP intervention consisted of four weekly group meetings led by two bachelor's level facilitators, each of which lasted approximately 50-min. The significant effects associated with the intervention have been reported elsewhere 26 and, thus, were not the focus of this report.…”

Section: Methodsmentioning

confidence: 99%

“…1,2 Injection drug users (IDUs) remain a target population as they continue to represent a critical vector for the transmission of new HIV infections, 3,4 which occurs primarily through drug-and sexual-related risk behaviors that are highly preventable. As there is currently no vaccine to prevent new HIV infections, behavioral interventions are our primary intervention tools.…”

Section: Introductionmentioning

confidence: 99%

“…15 Of particular relevance to the present study, findings point to the importance of addressing both drug-and sexual-related HIV risk behaviors and doing so in a balanced manner. Although there is accumulating evidence that more effective risk reduction interventions for IDUs tend to incorporate an equivalent focus on drug-and sexual-related risks, 3,4 research to date has not been designed to specify the role played by particular components that comprise such interventions. Therefore, our objective in the present study was to implement a structural equation modeling (SEM) approach to specify the pathways leading from our intervention components to the risk reduction outcomes that we observed.…”

Section: Introductionmentioning

confidence: 99%

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Optimizing a Community-Friendly HIV Risk Reduction Intervention for Injection Drug Users in Treatment: A Structural Equation Modeling Approach

Copenhaver

Lee

2006

J Urban Health

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Research on behavioral HIV risk reduction interventions for injection drug users (IDUs) has focused on primary outcomes (e.g., reduced injection drug use, increased condom use) but has not fully examined the respective roles played by intervention components on these primary outcomes. In this paper, we present a structural equation modeling (SEM) approach in which we specify the causal pathways leading from theory-based intervention components to risk reduction outcomes among a sample of primarily IDUs (n = 226) participating in an inner-city community-based methadone maintenance program. Similar pathways were found leading to both drugand sexual-related risk reduction outcomes. Findings suggest the importance of targeting participants' risk reduction motivation and behavioral skills versus employing more passive informational strategies. Findings also indicate that our intervention may be optimized by focusing more on participants' risk reduction motivation within the sexual-related content and placing equivalent emphasis on participants' risk reduction knowledge, motivation, and behavioral skills within the drug-related content. By quantifying the specific linkage between intervention components and risk reduction outcomes, our SEM findings offer empirical guidance for optimizing this intervention. This strategy may also serve as a useful theory-and data-driven means to inform the refinement of other behavioral interventions.

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Substitution treatment of injecting opioid users for prevention of HIV infection

Gowing¹,

Farrell

Bornemann

et al. 2004

Cochrane Database of Systematic Reviews

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Oral substitution treatment for opioid-dependent injecting drug users is associated with statistically significant reductions in illicit opioid use, injecting use and sharing of injecting equipment. It is also associated with reductions in the proportion of injecting drug users reporting multiple sex partners or exchanges of sex for drugs or money, but has little effect on condom use. It appears that the reductions in risk behaviours related to drug use do translate into reductions in cases of HIV infection. The lack of data from randomised controlled studies limits the strength of the evidence presented in this review. However, these findings add to the stronger evidence of effectiveness of substitution treatment on drug use, and treatment retention outcomes shown by other systematic reviews. On this basis, the provision of substitution treatment for opioid dependence in countries with emerging HIV and injecting drug use problems as well as in countries with established populations of injecting drug users should be supported.

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Targeting HIV-related outcomes with intravenous drug users maintained on methadone: A randomized clinical trial of a harm reduction group therapy

Cited by 97 publications

References 49 publications

The Effect of Intimate Partner Violence on Receptive Syringe Sharing Among Young Female Injection Drug Users: An Analysis of Mediation Effects

The Effect of Intimate Partner Violence on Receptive Syringe Sharing Among Young Female Injection Drug Users: An Analysis of Mediation Effects

Optimizing a Community-Friendly HIV Risk Reduction Intervention for Injection Drug Users in Treatment: A Structural Equation Modeling Approach

Substitution treatment of injecting opioid users for prevention of HIV infection

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