title: Effects of an HIV peer prevention intervention on sexual and injecting risk behaviors among injecting drug users and their risk partners in Thai Nguyen, Vietnam: a randomized controlled trial.
abstract: Globally, 30% of new HIV infections outside sub-Saharan Africa involve injecting drug users (IDU) and in many countries, including Vietnam, HIV epidemics are concentrated among IDU. We conducted a randomized controlled trial in Thai Nguyen, Vietnam, to evaluate whether a peer oriented behavioral intervention could reduce injecting and sexual HIV risk behaviors among IDU and their network members. 419 HIV-negative index IDU aged 18 years or older and 516 injecting and sexual network members were enrolled. Each index participant was randomly assigned to receive a series of six small group peer educator-training sessions and three booster sessions in addition to HIV testing and counseling (HTC) (intervention; n = 210) or HTC only (control; n = 209). Follow-up, including HTC, was conducted at 3, 6, 9 and 12 months post-intervention. The proportion of unprotected sex dropped significantly from 49% to 27% (SE (difference) = 3%, p < 0.01) between baseline and the 3-month visit among all index-network member pairs. However, at 12 months, post-intervention, intervention participants had a 14% greater decline in unprotected sex relative to control participants (Wald test = 10.8, df = 4, p = 0.03). This intervention effect is explained by trial participants assigned to the control arm who missed at least one standardized HTC session during follow-up and subsequently reported increased unprotected sex. The proportion of observed needle/syringe sharing dropped significantly between baseline and the 3-month visit (14% vs. 3%, SE (difference) = 2%, p < 0.01) and persisted until 12 months, but there was no difference across trial arms (Wald test = 3.74, df = 3, p = 0.44).
authors.affiliation: Johns Hopkins Bloomberg School of Public Health, Department of Epidemiology, 615 North Wolfe Street, E6610, Baltimore, MD 21205, USA. Electronic address: vgo@jhsph.edu.
authors.forename: Vivian F
authors.initials: VF
authors.lastname: Go
authors.forename: Constantine
authors.initials: C
authors.lastname: Frangakis
authors.forename: Nguyen
authors.initials: N
authors.lastname: Le Minh
authors.forename: Carl A
authors.initials: CA
authors.lastname: Latkin
authors.forename: Tran Viet
authors.initials: TV
authors.lastname: Ha
authors.forename: Tran Thi
authors.initials: TT
authors.lastname: Mo
authors.forename: Teerada
authors.initials: T
authors.lastname: Sripaipan
authors.forename: Wendy
authors.initials: W
authors.lastname: Davis
authors.forename: Carla
authors.initials: C
authors.lastname: Zelaya
authors.forename: Pham The
authors.initials: PT
authors.lastname: Vu
authors.forename: Yong
authors.initials: Y
authors.lastname: Chen
authors.forename: David D
authors.initials: DD
authors.lastname: Celentano
authors.forename: Vu Minh
authors.initials: VM
authors.lastname: Quan
mesh_terms: D000293:Adolescent; D000328:Adult; D055030:Drug Users / Q000523:psychology* / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016485:Needle Sharing / Q000706:statistics & numerical data; D010379:Peer Group; D015397:Program Evaluation; D012309:Risk-Taking; D012725:Sexual Behavior / Q000523:psychology* / Q000706:statistics & numerical data; D012747:Sexual Partners / Q000523:psychology*; D015819:Substance Abuse, Intravenous / Q000523:psychology*; D014744:Vietnam; D055815:Young Adult
keywords: Evaluation; HIV; Injecting drug use; Intervention; Peer network; Randomized controlled trial; Vietnam
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