El-Bassel, N., Gilbert, L., Terlikbayeva, A., et al. Journal of Acquired Immunodeficiency Syndrome (October 1, 2014), Vol. 67, No. 2, pp. 196–203.
The authors of this article described a randomized controlled trial in Kazakhstan to address the co-occurring epidemics of HIV and hepatitis C virus (HCV) infection among persons who inject drugs (PWID). This study tested the efficacy of a behavioral, couple-based intervention aimed at reducing: (1) incidence of unprotected sex and of HIV, HCV, and other sexually transmitted infections (STIs), and (2) unsafe injection practice among PWID and their partners. A total of 300 eligible participants were recruited from health clinics, harm reduction service centers, and PWID networks in the city of Almaty. Participants were randomly assigned to either a five-session risk reduction (RR) intervention, or a five-session wellness promotion (WP) intervention (the control group). At the 12-month follow-up, participants in the RR arm had 51 percent lower incidence of HIV infection and 69 percent lower HVC infection than the WP control participants. Participants in the RR arm also showed a 42 percent lower incidence of unprotected sex with their partners, compared to those in the WP arm. The authors concluded that behavioral interventions can provide significant impact to HIV/HCV/STI prevention efforts, and should be scaled up for PWID in harm reduction programs, drug treatment, and criminal justice settings.