New Method to Lower HIV Risk

HIV transmission risk lowered when injection drug users get safety education from peers

/ Author:  / Reviewed by: Chris Galloway, M.D.

(RxWiki News) Training individuals who use illegal injection drugs on safer practices may help other drug users in the community improve safety. Safer practices could lower risk of spreading HIV.

A recent study tested whether health and safety practices among injection drug users could be improved through peer education. The researchers aimed to see whether people in the same drug-using circles could influence safe practices among one another.

The results of the study showed that drug users shared needles, cookers and drug doses less often when peers within their group were educated on safety and how to tell others about safety.

The authors said they believed this practice could lower the risk of HIV among injection drug users.

"Never share injection materials."

Carl Latkin, PhD, from the Department of Health, Behavior and Society at Johns Hopkins Bloomberg School of Public Health in Baltimore, MD, led an investigation into how socially acceptable behavior among injection drug users impacts the spread of the human immunodeficiency virus (HIV).

HIV can be spread, or transmitted, through drug users sharing needles, drugs and other drug paraphernalia.

The HIV Prevention Trials Network Study recruited 652 people who used illegal injection drugs, but were not infected with HIV for this study.

Researchers were looking to see if educating drug users on risky injection-related behaviors that lead to HIV transmission would change how socially acceptable these risky behaviors were.

Then they hoped to see whether that education could lead to improved safety practices among injection drug users.

Participants were split into two groups and followed for 30 months. The first group received education on HIV transmission risks, health and safety with needle sharing, safe sex practices and how to share this safety information with others. The second group only had access to two voluntary, basic HIV testing and counseling sessions.

Every six months, researchers asked participants whether they engaged in certain risky injection-related behaviors and whether these behaviors were practiced and accepted by their peers.

The behaviors the researchers looked at included the following:

  • Sharing needles
  • Sharing the spoons or cookers used to heat the drugs
  • Sharing the cotton used to filter the drug from the cooker to the needle
  • Front/back load with shared syringe (one syringe is used to suck up the drug solution out of the cooker, then the contents are transferred into another or multiple syringes)

At the start of the study, 39 percent of all the users shared needles, 61 percent shared cookers, 45 percent shared cotton filters and 22 percent participated in front/back loading syringes.

Socially acceptable behavior, or social norms, among the drug users heavily influenced injection-related risk behaviors. Participants were nine times more likely to share a cooker and 4.5 times more likely to share cotton filters if their group of friends did so regularly.

By the end of the study, participants who were trained on health and safety reported more safe behavior by themselves and among those in their drug using groups. The odds of sharing needles dropped by nearly half, the odds of sharing a cooker dropped by nearly one-third and the odds of front/back loading dropped by almost one half.

“The results of this study suggest that peer-based interventions to reduce HIV injection behaviors can change social norms as well as behaviors,” the authors concluded.

Educating people in high-risk groups on safety practices to share with their peers may be a way to improve health and safety within those high-risk groups, the study showed.

This study was published in January in Addiction.

HIV Prevention Trials Network, several departments within the National Institutes of Health, the Office of Aids Research and several publicly funded government health agencies and academic institutions provided funding for this project. No conflicts of interest were found.

Reviewed by: 
Review Date: 
February 7, 2013
Last Updated:
February 10, 2013