Interventions with injection drug users in Ukraine.

Area of Science:

• Public Health
• Infectious Disease Epidemiology
• Behavioral Science

Background:

• Injection drug users (IDUs) are a key population for HIV prevention efforts.
• Street-based interventions for IDUs can be time-consuming and costly.
• Assessing the effectiveness of brief interventions is crucial for optimizing public health resources.

Purpose of the Study:

• To compare the effectiveness of a brief HIV testing and counseling intervention against a more intensive street-based intervention for IDUs.
• To evaluate the impact of HIV status awareness on risk behaviors among IDUs.

Main Methods:

• A cross-over experimental design was employed with 1798 injection drug users (IDUs) recruited in Ukraine.
• Participants underwent HIV testing and completed audio computer-assisted self-interviews (ACASI) assessing socio-demographics, drug use, and risk behaviors.
• Baseline and 6-month follow-up assessments were conducted.

Main Results:

• Both intervention groups showed significant reductions in injection and sexual risk behaviors.
• Awareness of HIV infection at baseline was associated with significantly improved safe sex practices.
• Newly diagnosed IDUs demonstrated greater changes in safe sex practices compared to those already aware or HIV-negative.
• Younger IDUs and those with shorter injection histories exhibited higher risk behaviors post-intervention.

Conclusions:

• HIV status awareness is linked to reduced sexual risk behaviors among street-recruited IDUs.
• Targeted interventions are needed for younger IDUs and those with less experience in drug injection.
• Brief HIV testing and counseling interventions show promise in reducing risk behaviors within this population.