title: A randomized intervention trial to reduce the lending of used injection equipment among injection drug users infected with hepatitis C.
abstract: OBJECTIVE
  We evaluated the efficacy of a peer-mentoring behavioral intervention designed to reduce risky distributive injection practices (e.g., syringe lending, unsafe drug preparation) among injection drug users with hepatitis C virus (HCV) infection.
  
  
  METHODS
  A randomized trial with a time-equivalent attention-control group was conducted among 418 HCV-positive injection drug users aged 18 to 35 years in 3 US cities. Participants reported their injection-related behaviors at baseline and at 3- and 6-month follow-ups.
  
  
  RESULTS
  Compared with the control group, intervention-group participants were less likely to report distributive risk behaviors at 3 months (odds ratio [OR]=0.46; 95% confidence interval [CI]=0.27, 0.79) and 6 months (OR=0.51; 95% CI=0.31, 0.83), a 26% relative risk reduction, but were no more likely to cite their HCV-positive status as a reason for refraining from syringe lending. Effects were strongest among intervention-group participants who had known their HCV-positive status for at least 6 months. Peer mentoring and self-efficacy were significantly increased among intervention-group participants, and intervention effects were mediated through improved self-efficacy.
  
  
  CONCLUSIONS
  This behavioral intervention reduced unsafe injection practices that may propagate HCV among injection drug users.
authors.affiliation: Division of International Health and Cross Cultural Medicine, University of California School of Medicine, 9500 Gilman Dr, Mailstop 0622, La Jolla, CA 92093, USA.
authors.forename: Mary H
authors.initials: MH
authors.lastname: Latka
authors.forename: Holly
authors.initials: H
authors.lastname: Hagan
authors.forename: Farzana
authors.initials: F
authors.lastname: Kapadia
authors.forename: Elizabeth T
authors.initials: ET
authors.lastname: Golub
authors.forename: Sebastian
authors.initials: S
authors.lastname: Bonner
authors.forename: Jennifer V
authors.initials: JV
authors.lastname: Campbell
authors.forename: Micaela H
authors.initials: MH
authors.lastname: Coady
authors.forename: Richard S
authors.initials: RS
authors.lastname: Garfein
authors.forename: Minya
authors.initials: M
authors.lastname: Pu
authors.forename: Dave L
authors.initials: DL
authors.lastname: Thomas
authors.forename: Thelma K
authors.initials: TK
authors.lastname: Thiel
authors.forename: Steffanie A
authors.initials: SA
authors.lastname: Strathdee
mesh_terms: D000293:Adolescent; D000328:Adult; D001521:Behavior Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006526:Hepatitis C / Q000150:complications* / Q000517:prevention & control / Q000635:transmission; D006801:Humans; D008297:Male; D008611:Mentors; D016485:Needle Sharing / Q000009:adverse effects*; D012309:Risk-Taking; D015819:Substance Abuse, Intravenous / Q000150:complications* / Q000523:psychology / Q000534:rehabilitation; D014481:United States