Peer-Education Intervention to Reduce Injection Risk Behaviors Benefits High-Risk Young Injection Drug Users: A Latent Transition Analysis of the CIDUS 3/DUIT Study

Mary E. Mackesy-Amiti,Lorna Finnegan,Elizabeth T. Golub,Richard S. Garfein,Holly Hagan,Lawrence J. Ouellet,Sharon M. Hudson,Mary H. Latka

doi:10.1007/s10461-012-0373-0

Abstract

We analyzed data from a large randomized HIV/HCV prevention intervention trial with young injection drug users (IDUs) conducted in five U.S. cities. The trial compared a peer education intervention (PEI) with a time-matched, attention control group. Applying categorical latent variable analysis (mixture modeling) to baseline injection risk behavior data, we identified four distinct classes of injection-related HIV/HCV risk: low risk, non-syringe equipment-sharing, moderate-risk syringe-sharing, and high-risk syringe-sharing. The trial participation rate did not vary across classes. We conducted a latent transition analysis using trial baseline and 6-month follow-up data, to test the effect of the intervention on transitions to the low-risk class at follow-up. Adjusting for gender, age, and race/ethnicity, a significant intervention effect was found only for the high-risk class. Young IDU who exhibited high-risk behavior at baseline were 90 % more likely to be in the low-risk class at follow-up after the PEI intervention, compared to the control group.

Highlights

124.41 \0.0001 1435 effect remained significant for baseline high-risk participants, the effect for baseline low-risk participants did not (p = 0.061). In this sample of young injection drug users (IDUs) recruited in five different cities, we identified four distinct classes of injection risk behavior
The latent transition analysis indicated that the drug users intervention trial (DUIT) peer education intervention (PEI) intervention was most beneficial for young IDUs who exhibited high-risk behavior
IDUs with lower levels of risk behavior may respond just as well to less intensive interventions. These results suggest that targeting the PEI intervention to young IDUs with a high-risk profile may be an efficient approach

Summary

Introduction

J. Ouellet Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, IL, USA. Garfein Division of Global Public Health, School of Medicine, University of California, San Diego, CA, USA equipment-sharing, moderate-risk syringe-sharing, and highrisk syringe-sharing. We conducted a latent transition analysis using trial baseline and 6-month follow-up data, to test the effect of the intervention on transitions to the low-risk class at follow-up. In 2007, an estimated 15 % of reported HIV cases among adults and adolescents in the U.S (N = 9,200) were associated with injection drug use or sexual contact with injection drug users (IDUs). 21 % of reported HIV cases among children (\13 years) were associated with injection drug use by the mother or the mother’s sexual partner [2]

Methods

Results

Conclusion