Kapadia Farzana, Latka Mary H, Hagan Holly, Golub Elizabeth T, Campbell Jennifer V, Coady Micaela H, Garfein Richard S, Thomas David L, Bonner Sebastian, Thiel Thelma, Strathdee Steffanie A
Guttmacher Institute, New York, NY 10005, USA.
J Urban Health. 2007 Jan;84(1):99-115. doi: 10.1007/s11524-006-9133-7.
Hepatitis C virus (HCV) is hyperendemic among injection drug users (IDUs). However, few scientifically proven interventions to prevent secondary transmission of HCV from infected IDUs to others exist. This report describes the design, feasibility, and baseline characteristics of participants enrolled in the Study to Reduce Intravenous Exposure (STRIVE). STRIVE was a multisite, randomized-control trial to test a behavioral intervention developed to reduce distribution of used injection equipment (needles, cookers, cottons, and rinse water) and increase health-care utilization among antibody HCV (anti-HCV) positive IDUs. STRIVE enrolled anti-HCV positive IDU in Baltimore, New York City, and Seattle; participants completed behavioral assessments and venipuncture for HIV, HCV-RNA, and liver function tests (LFTs) and were randomized to attend either a six-session, small-group, peer-mentoring intervention workshop or a time-matched, attention-control condition. Follow-up visits were conducted at 3 and 6 months. At baseline, of the 630 HCV-positive IDUs enrolled (mean age of 26 years, 60% white, 76% male), 55% reported distributive needle sharing, whereas 74, 69, and 69% reported sharing cookers, cottons, and rinse water, respectively. Health-care access was low, with 41% reporting an emergency room as their main source of medical care. Among those enrolled, 66% (418/630) were randomized: 53% (222/418) and 47% (196/418) to the intervention and control conditions, respectively. Follow-up rates were 70 and 73% for the 3- and 6-month visits, respectively. As distributive sharing of used injection equipment was common while reports of receiving HCV care were low, these findings indicate an urgent need for HCV-related interventions with IDUs and demonstrate the acceptability and feasibility to do so.
丙型肝炎病毒（HCV）在注射吸毒者（IDU）中高度流行。然而，几乎没有经过科学验证的干预措施来预防HCV从受感染的注射吸毒者向他人的二次传播。本报告描述了参与减少静脉暴露研究（STRIVE）的参与者的设计、可行性和基线特征。STRIVE是一项多中心随机对照试验，旨在测试一种行为干预措施，该措施旨在减少用过的注射设备（针头、煮器、棉球和冲洗水）的传播，并提高HCV抗体（抗-HCV）阳性注射吸毒者的医疗保健利用率。STRIVE在巴尔的摩、纽约市和西雅图招募了抗-HCV阳性注射吸毒者；参与者完成了行为评估以及针对HIV、HCV-RNA和肝功能测试（LFT）的静脉穿刺，并被随机分配参加为期六节的小组同伴指导干预研讨会或时间匹配的注意力控制组。在3个月和6个月时进行随访。基线时，在招募的630名HCV阳性注射吸毒者中（平均年龄26岁，60%为白人，76%为男性），55%报告有分发针头共用情况，而分别有74%、69%和69%报告共用煮器、棉球和冲洗水。获得医疗保健的机会较低，41%报告急诊室是他们主要的医疗保健来源。在招募的人员中，66%（418/630）被随机分组：分别有53%（222/418）和47%（196/418）被分配到干预组和对照组。3个月和6个月随访的随访率分别为70%和73%。由于用过的注射设备的分发共用情况很常见，而接受HCV护理的报告率较低，这些发现表明迫切需要对注射吸毒者采取与HCV相关的干预措施，并证明了这样做的可接受性和可行性。
