Results from a randomized controlled trial of a peer-mentoring intervention to reduce HIV transmission and increase access to care and adherence to HIV medications among HIV-seropositive injection drug users.
BACKGROUND
There is a lack of effective behavioral interventions for HIV-positive injection drug users (IDUs). We sought to evaluate the efficacy of an intervention to reduce sexual and injection transmission risk behaviors and to increase utilization of medical care and adherence to HIV medications among this population.


METHODS
HIV-positive IDUs (n=966) recruited in 4 US cities were randomly assigned to a 10-session peer mentoring intervention or to an 8-session video discussion intervention (control condition). Participants completed audio computer-assisted self-interviews and had their blood drawn to measure CD4 cell count and viral load at baseline and at 3-month (no blood), 6-month, and 12-month follow-ups.


RESULTS
Overall retention rates for randomized participants were 87%, 83%, and 85% at 3, 6, and 12 months, respectively. Participants in both conditions reported significant reductions from baseline in injection and sexual transmission risk behaviors, but there were no significant differences between conditions. Participants in both conditions reported no change in medical care and adherence, and there were no significant differences between conditions.


CONCLUSIONS
Both interventions led to decreases in risk behaviors but no changes in medical outcomes. The characteristics of the trial that may have contributed to these results are examined, and directions for future research are identified.
Purcell
David W
DW
Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. dpurcell@cdc.gov
Latka
Mary H
MH
Metsch
Lisa R
LR
Latkin
Carl A
CA
Gómez
Cynthia A
CA
Mizuno
Yuko
Y
Arnsten
Julia H
JH
Wilkinson
James D
JD
Knight
Kelly R
KR
Knowlton
Amy R
AR
Santibanez
Scott
S
Tobin
Karin E
KE
Rose
Carol Dawson
CD
Valverde
Eduardo E
EE
Gourevitch
Marc N
MN
Eldred
Lois
L
Borkowf
Craig B
CB
D000328:Adult; D032763:Behavior Control / Q000379:methods; D018791:CD4 Lymphocyte Count; D003140:Communicable Disease Control / Q000379:methods*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D012309:Risk-Taking; D015819:Substance Abuse, Intravenous; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D019562:Viral Load