Intervention Description
Intervention Package Information
Evaluation Study and Results
References and Contact Information
Intervention Description
Target Population
HIV-negative injection drug users with hepatitis C virus (HCV) infection
Goals of Intervention
- Eliminate or reduce risky injection
practices (e.g. syringe lending, unsafe
drug preparation)
- Eliminate or reduce the spread of
HCV
Brief Description
STRIVE is a 6-session,
group-level, peer mentoring intervention
designed to prevent high-risk drug
injection behaviors among injection drug
users (IDUs). The intervention is
delivered by two trained facilitators to
groups of 5 to 9 persons. The
intervention aims to reduce HCV
transmission risk by training
participants to mentor other IDUs and to
promote risk reduction information. A
harm reduction approach is used to
promote distributive risk reduction
options. The intervention also
emphasizes participants to set an
example for their close peers through
their own safer injection practices. The
peer mentoring role also provides
participants with a new “prosocial”
identity which reinforces their
motivation to practice and promote safer
injection drug behaviors. The first 4
sessions of the intervention increase
knowledge about HCV, and provide skills
to reduce injection behaviors and
alcohol use. These sessions also help
participants manage their HCV health
care, and teach them how to effectively
conduct educational outreach to other
IDUs. The final 2 sessions provide
participants with communication
techniques to facilitate HCV-related
peer mentoring and to conduct peer
mentoring in community-based settings.
The intervention content is delivered
through demonstrations, games, group
discussions, skills-building exercises,
street outreach activities, and videos. |
Theoretic Basis
- Cognitive Behavioral Theory
- Social Learning Theory
Intervention Duration
Six 2-hour sessions delivered twice a week
over a 3-week period
Intervention Settings
Private meeting room at the research
site
Deliverer
Two trained facilitators
Delivery Methods
- Demonstrations
- Discussion
- Exercises/Games
- Practice
- Role plays
- Videos
Go to top
Intervention Package Information
An intervention package is not available at this time. Please contact Dr.
Steffanie A. Strathdee, Division of International Health
Department of Medicine
University of California San Diego, 10111 N. Torrey Pines Rd.
La Jolla, CA
92093-0507, email:
sstrathdee@ucsd.edu, for details on intervention materials.
Go to top
Evaluation Study and Results
The original evaluation study was
conducted in Baltimore, Maryland, New York
City, New York, and Seattle, Washington
between 2002 and 2004.
Key Intervention Effects
- Reduced distributive risk among
those continuing to inject drugs
- Reduced frequency of preparing drugs
with a syringe previously used by
oneself
- Reduced sharing drug preparation
equipment
- Increased refraining from injection
drug use
- Reduced frequency of injecting self
with used syringe
Study Sample
The baseline study sample of 418 HIV-negative and HCV-positive injection
drug users is characterized by the
following:
- 57% White, 27% Hispanic, 7%
African American, 10% Other
- 76% Men, 24% Women
- Mean age of 27 years
Recruitment Settings
Referrals from other research studies (e.g., Collaborative Injection
Drug Users Studies-III/Drug Users
Intervention Trial, CIDUS-II/DUIT; or
studies being conducted at the Seattle and
New York City sites)
Eligibility Criteria
Men and women were eligible if they were
between 18 and 35 years old, reported
injection drug use during the 6 months
preceding screening, planned on living in
the area for the next 12 months, provided
documentation of their anti-HCV positive and
HIV-negative serostatus, were willing to
provide a blood sample for liver function
and HCV-RNA testing, and were able to
comprehend English well enough to complete
assessments and participate in group
discussions.
Assignment Method
Injection drug users (N = 418) were randomly assigned to 1 of 2
groups: Peer Mentoring Intervention (n =
222) or Video Discussion Comparison (n =
196).
Comparison Group
The comparison group consisted of six
2-hour group sessions over 3 weeks. In each
session, participants watched a docudrama
television series focusing on the lives of
young injection drug users living in an
urban setting, and then participated in a
facilitated group discussion led by the same
two trained facilitators as the intervention
group. Facilitators used a scripted manual
to guide discussion around family,
education, self-respect, relationships,
violence, parenting, and employment.
Participants were referred to a resource
table for more information on risk reduction
and access to health care.
Relevant Outcomes Measured and Follow-up Time
- Injection drug risk behaviors during
past 3 months (including frequency of
lending used syringe to others,
frequency of preparing drugs with a
syringe previously used, frequency of
sharing drug preparation equipment with
or before someone else, refrained from
injection drug use, refrained from
lending syringe because of HCV-positive
status, and frequency of injecting
oneself with used syringe) were measured
at 3 and 6 months after the
intervention.
- A combined distributive risk
indicator was created by combining three
injection drug risk behaviors: lending
one’s used syringe, preparing drugs with
a syringe one had previously used,
sharing drug preparation equipment or
injecting drugs.
Participant Retention
- Peer Mentoring Intervention:
66% retained at 3 months
81% retained at 6 months
- Video Discussion Comparison:
66% retained at 3 months
80% retained at 6 months
Significant Findings
- At the 6-month follow-up, the Peer
Mentoring Intervention participants
reported significantly lower levels in
the combined distributive risk indicator
(p = .006) and sharing drug preparation
equipment (p = .03), compared to the
Video Discussion Comparison
participants.
- At the 3-month follow-up,
intervention participants reported
significantly lower levels of the
following outcomes than comparison
participants: combined distributive risk
indicator (p = .004), frequency of
preparing drugs with a syringe
previously used by oneself (p = .03),
sharing drug preparation equipment (p =
.008), refraining from injection drug
use (p = .001), and frequency of
injecting self with used syringe (p =
.01). (These findings meet the promising
criteria due to the retention rates less
than 70%).
Considerations
Go to top
References and Contact Information
- Latka, M. H., Hagan, H., Kapadia, F., Golub, E. T., Bonner, S., Campbell,
J. V., et al. (2008). A randomized intervention trial to reduce the lending
of used injection equipment among injection drug users infected with
hepatitis C. American Journal of Public Health, 98, 853-861.
- Kapadia, F., Latka, M. H., Hagan, H., Golub, E. T., Campbell, J. V.,
Coady, M. H., et al. (2007). Design and feasibility of a randomized
behavioral intervention to reduce distributive injection risk and improve
health-care access among hepatitis C virus positive injection drug users:
The Study to Reduce Intravenous Exposures (STRIVE). Journal of Urban
Health, 84, 99-115.
Researcher: Steffanie A. Strathdee, PhD
Division of International Health
Department of Medicine
University of California San Diego
10111 N. Torrey Pines Rd.
La Jolla, CA
92093-0507
email: sstrathdee@ucsd.edu
Go to top
|