title: A Systematic Review and Meta-analysis of Psychosocial Interventions to Reduce Drug and Sexual Blood Borne Virus Risk Behaviours Among People Who Inject Drugs.
abstract: Opiate substitution treatment and needle exchanges have reduced blood borne virus (BBV) transmission among people who inject drugs (PWID). Psychosocial interventions could further prevent BBV. A systematic review and meta-analysis examined whether psychosocial interventions (e.g. CBT, skills training) compared to control interventions reduced BBV risk behaviours among PWID. 32 and 24 randomized control trials (2000-May 2015 in MEDLINE, PsycINFO, CINAHL, Cochrane Collaboration and Clinical trials, with an update in MEDLINE to December 2016) were included in the review and meta-analysis respectively. Psychosocial interventions appear to reduce: sharing of needles/syringes compared to education/information (SMD -0.52; 95% CI -1.02 to -0.03; I2= 10%; p = 0.04) or HIV testing/counselling (SMD -0.24; 95% CI -0.44 to -0.03; I2= 0%; p = 0.02); sharing of other injecting paraphernalia (SMD -0.24; 95% CI -0.42 to -0.06; I2= 0%; p < 0.01) and unprotected sex (SMD -0.44; 95% CI -0.86 to -0.01; I2= 79%; p = 0.04) compared to interventions of a lesser time/intensity, however, moderate to high heterogeneity was reported. Such interventions could be included with other harm reduction approaches to prevent BBV transmission among PWID.
authors.affiliation: National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 4 Windsor Walk, London, SE5 8BB, UK. gail.gilchrist@kcl.ac.uk.|Department of General Practice, University of Melbourne, Parkville, VIC, 3010, Australia. gail.gilchrist@kcl.ac.uk.
authors.forename: Gail
authors.initials: G
authors.lastname: Gilchrist
authors.affiliation: National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 4 Windsor Walk, London, SE5 8BB, UK.
authors.forename: Davina
authors.initials: D
authors.lastname: Swan
authors.affiliation: National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 4 Windsor Walk, London, SE5 8BB, UK.
authors.forename: Kideshini
authors.initials: K
authors.lastname: Widyaratna
authors.affiliation: Department of Psychiatry and Clinical Psychobiology, School of PsychologyUniversity of Barcelona, 08036, Barcelona, Spain.
authors.forename: Julia Elena
authors.initials: JE
authors.lastname: Marquez-Arrico
authors.affiliation: University of Huddersfield, Huddersfield, HD1 3DH, UK.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Hughes
authors.affiliation: Mental Health and Addiction Research Group, Department of Health Sciences, University of York, York, YO24 2YD, UK.
authors.forename: Noreen Dadirai
authors.initials: ND
authors.lastname: Mdege
authors.affiliation: School for Health and Related Research, University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK.
authors.forename: Marrissa
authors.initials: M
authors.lastname: Martyn-St James
authors.affiliation: Addiction Research Group, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Institute of Neuropsychiatry and Addictions, Parc de Salut Mar de Barcelona, 08003, Barcelona, Spain.
authors.forename: Judit
authors.initials: J
authors.lastname: Tirado-Munoz
mesh_terms: D015928:Cognitive Behavioral Therapy; D003376:Counseling; D015658:HIV Infections / Q000517:prevention & control*; D040261:Harm Reduction; D006526:Hepatitis C / Q000517:prevention & control*; D006801:Humans; D016485:Needle Sharing; D010353:Patient Education as Topic; D012306:Risk; D040242:Risk Reduction Behavior; D012309:Risk-Taking; D012725:Sexual Behavior; D015819:Substance Abuse, Intravenous; D047568:Unsafe Sex / Q000517:prevention & control*
keywords: Blood borne virus; Injecting risk behaviour; Meta-analysis; People who inject drugs; Psychosocial intervention; Sexual risk behaviour; Systematic review