Latka Mary H, Hagan Holly, Kapadia Farzana, Golub Elizabeth T, Bonner Sebastian, Campbell Jennifer V, Coady Micaela H, Garfein Richard S, Pu Minya, Thomas Dave L, Thiel Thelma K, Strathdee Steffanie A
Division of International Health and Cross Cultural Medicine, University of California School of Medicine, 9500 Gilman Dr, Mailstop 0622, La Jolla, CA 92093, USA.
Am J Public Health. 2008 May;98(5):853-61. doi: 10.2105/AJPH.2007.113415. Epub 2008 Apr 1.
We evaluated the efficacy of a peer-mentoring behavioral intervention designed to reduce risky distributive injection practices (e.g., syringe lending, unsafe drug preparation) among injection drug users with hepatitis C virus (HCV) infection.
A randomized trial with a time-equivalent attention-control group was conducted among 418 HCV-positive injection drug users aged 18 to 35 years in 3 US cities. Participants reported their injection-related behaviors at baseline and at 3- and 6-month follow-ups.
Compared with the control group, intervention-group participants were less likely to report distributive risk behaviors at 3 months (odds ratio [OR]=0.46; 95% confidence interval [CI]=0.27, 0.79) and 6 months (OR=0.51; 95% CI=0.31, 0.83), a 26% relative risk reduction, but were no more likely to cite their HCV-positive status as a reason for refraining from syringe lending. Effects were strongest among intervention-group participants who had known their HCV-positive status for at least 6 months. Peer mentoring and self-efficacy were significantly increased among intervention-group participants, and intervention effects were mediated through improved self-efficacy.
This behavioral intervention reduced unsafe injection practices that may propagate HCV among injection drug users.
我们评估了一种同伴指导行为干预措施的效果，该措施旨在减少丙型肝炎病毒（HCV）感染的注射吸毒者中危险的分发注射行为（如共用注射器、不安全的药物制备）。
在美国3个城市对418名年龄在18至35岁的HCV阳性注射吸毒者进行了一项设有时间等效注意力控制组的随机试验。参与者在基线以及3个月和6个月随访时报告他们与注射相关的行为。
与对照组相比，干预组参与者在3个月时（优势比[OR]=0.46；95%置信区间[CI]=0.27，0.79）和6个月时（OR=0.51；95%CI=0.31，0.83）报告分发风险行为的可能性较小，相对风险降低了26%，但将其HCV阳性状态作为拒绝共用注射器的原因的可能性并没有增加。在已知其HCV阳性状态至少6个月的干预组参与者中，效果最为明显。干预组参与者的同伴指导和自我效能感显著提高，干预效果通过提高自我效能感来介导。
这种行为干预减少了可能在注射吸毒者中传播HCV的不安全注射行为。
