Effectiveness of psychosocial interventions in preventing HIV risk behaviour in injecting drug users

Abstract

A close examination of the evidence and competing hypotheses for the pattern of results suggests that participating in evaluation research may itself be a valuable intervention. Implications for the development of interventions include the potential efficacy of health risk assessment. Implications for evaluation of interventions include the need for developing unobtrusive measures and for assessing the impact of behavioural assessments. Despite the large behavioural changes reported in most of the studies, a substantial proportion of subjects receiving interventions reported unacceptably high levels of risk behaviours. New, more potent interventions are needed, such as those designed to change the norms of entire communities of drug users concerning safer injection and safer sex.

Characteristics of Aboriginal Injecting Drug Users in Sydney, Australia: Prison History, Hepatitis C Status and Drug Treatment Experiences

“…Aboriginal females were less likely to have reported being recently tested for HCV than the non-Aboriginal females, indicating that HCV may be higher than reported. As demonstrated with HIV, pre-and post-test counselling can reduce risk behaviour (Gibson, McCusker, & Chesney, 1998). That large proportions of IDUs had not received counselling (or do not remember anything of the process) is of concern and has implications in terms of the prevention of blood-borne viral transmission and requires further investigation.…”

Efficacy of a behavioral intervention for increasing safer sex behaviors in HIV-positive MSM methamphetamine users: Results from the EDGE study

“…In general, interventions have been more successful in reducing high risk drug-using behaviors (e.g., drug injection, multiperson reuse of syringes and needles) than sexual risk behaviors (Booth and Watters, 1994;Gibson et al, 1998). Moreover, these interventions have targeted injection drug users, most of whom are heterosexual (Kanouse, Bluthenthal, Bogart, et al, 2005).…”

Behavior Change and Health-Related Interventions for Heterosexual Risk Reduction Among Drug Users

“…It is only recently that interventions to reduce the sexual transmission of HIV to drug users have been conducted with HIV-seropositive drug users. We review first the evidence for sex risk reduction interventions implemented with HIVseronegative drug users and then summarize the emerging literature on risk reduction interventions with HIV-seropositive IDUs.Studies With HIV-Seronegative Drug Users-Qualitative reviews of U.S.-based intervention studies conducted mostly with seronegative IDUs first appeared in the literature in the early 1990s (Booth and Watters, 1994; Brown et al, 1993) and continued throughout the 1990s (Coyle et al, 1998;Gibson et al, 1998). Although these reviews showed that drug users, mainly heroin injectors, reduced their sex risk behaviors, they also noted the relatively large number of studies conducted in the 1990s in which there were no differences at followup between the rates of sexually risky behaviors of participants in the intervention groups and in the comparison groups.…”

“…Taking into consideration the social, environmental, and normative context for HIV risk reduction, calls are still being made to adapt even the theoretical models of behavior change to the culture and context of local community norms and to the traditional practices of resource-constrained settings (Odutolu, 2005). Although these calls have been made in reference to heterosexual populations other than drug users, the same phenomenon, promotion of protective peer and social norms, applies to drug users (Gibson et al, 1998). This adaptation process is especially relevant to sexual behaviors because individual behaviors are shaped by social norms and because the process of behavior change goes beyond the individual decision making process.…”