Hoffman, I.F., Latkin, C.A., Kukhareva, P.V., et al. AIDS and Behavior (September 2013), Vol. 17 No. 7, pp. 2510-2520.
In Russia, people who inject drugs (PWID) typically interact within small networks that may influence the HIV epidemic. The authors described the results of a randomized controlled trial assessing the effectiveness of a peer-educator intervention for PWID and their network members in St. Petersburg, aimed at reducing HIV incidence and risk behaviors. The findings indicated that peer-education interventions may reduce HIV incidence within marginalized PWID networks and should be included in a comprehensive HIV prevention approach. From December 2004 to November 2007, index participants were recruited and encouraged to identify network participant(s). In total, 432 participants enrolled and were randomized to the intervention or control. Intervention index participants attended eight training sessions on the risks of injecting drug use, sexual risk behavior, and risk reduction and communication skills. Control index participants attended sessions on social development skills and lifestyle discussions. Of 240 HIV-negative participants (at baseline), 160 participants received follow-up visit(s). At follow-up, estimated HIV incidences were 7.8 and 19.6 in the intervention and control groups, respectively. Analysis comparing HIV incidence between the groups using parametric, semi-parametric, and non-parametric estimates had similar results, showing that incidence in the control group was approximately two times greater. Future research may benefit from measuring a community effect instead of individual HIV incidence.