Willingness to engage in peer-delivered HIV voluntary counselling and testing among people who inject drugs in a Canadian setting.
BACKGROUND
People who inject drugs (IDU) face unique systemic, social and individual barriers to conventional HIV voluntary counselling and testing (VCT) programmes. Peer-delivered approaches represent a possible alternative to improve rates of testing among this population.


METHODS
Cross-sectional data from a prospective cohort of IDU in Vancouver, Canada, were collected between December 2011 and May 2012. Bivariate statistics and multivariate logistic regression were used to identify the prevalence of and factors associated with willingness to receive peer-delivered VCT.


RESULTS
Of 600 individuals, 51.5% indicated willingness to receive peer-delivered pretest counselling, 40.7% to receive peer-delivered rapid HIV testing and 42.8% to receive peer-delivered post-test counselling. Multivariate analyses found significant positive associations between willingness for pretest counselling and having used Vancouver's supervised injection facility, Insite, or being a member of VANDU (a local drug user organisation) (all p<0.05). Daily crack smoking and having used Insite were positively associated with willingness to receive peer-delivered HIV testing (p<0.05). Willingness to receive peer-delivered post-test counselling was positively associated with male gender, daily crack smoking, having used Insite and being a member of VANDU (p<0.05).


CONCLUSIONS
While not universally acceptable, peer-delivered VCT approaches may improve access to HIV testing among IDU.
British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, British Columbia, Canada School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.
Nicole
N
Markwick
British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, British Columbia, Canada School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.
Lianping
L
Ti
British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, British Columbia, Canada.
Cody
C
Callon
School of Public Health, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
Cindy
C
Feng
British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, British Columbia, Canada Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Evan
E
Wood
British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, British Columbia, Canada Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Thomas
T
Kerr
D001955:British Columbia; D003376:Counseling; D003430:Cross-Sectional Studies; D005260:Female; D006679:HIV Seropositivity / Q000175:diagnosis*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data; D010379:Peer Group; D015819:Substance Abuse, Intravenous; D011795:Surveys and Questionnaires; D014505:Urban Population; D014838:Volunteers
ADDICTIVE BEHAVIOUR/ADDICTION; DRUG MISUSE; HIV; PUBLIC HEALTH