Peer-driven HIV interventions for drug injectors in Russia: First year impact results of a field experiment
Peer-driven HIV interventions for drug injectors in Russia: First year impact results of a field experiment
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DOI：
10.1016/j.drugpo.2006.06.001
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发表时间：
2006-09-01
影响因子：
4.4
通讯作者：
Heckathorn, Douglas D.
中科院分区：
文献类型：
--
作者：
Broadhead, Robert S.;Volkanevsky, Valerii L.;Heckathorn, Douglas D.
我们报告了俄罗斯西部两个城市针对注射吸毒者 (IDU) 的艾滋病毒预防现场实验第一年的影响结果，比较了布拉吉诺的标准“同伴驱动干预”(PDI) 和雷宾斯克的简化 PDI。 PDI 依靠注射吸毒者在社区中相互进行艾滋病毒预防教育，并招募同伴来加强预防服务和教育。在标准 PDI 中，注射吸毒者招募者会获得象征性的金钱奖励，以招募同伴并对其进行一系列预防信息的教育。在简化 PDI 中，注射吸毒者招募者同样被要求教育和招募他们的同伴，但招募的奖励融入到他们的教育工作中。这一修改简化了模型的运营，并使受访者费用降低了 50%。最重要的研究问题是 PDI 奖励结构的修改是否会影响模型的招募力和教育效果。第一年的结果表明，尽管标准 PDI 的表现比简化 PDI 高出约 35%（分别为 493 名新兵和 365 名新兵），但两种 PDI 都实现了较高的基线招募率。然而，简化 PDI 中的 IDU 招聘人员在基线（8 分制平均知识测试得分为 5.19 比 4.07）和 6 个月后随访（8 分制平均知识测试得分为 7.21 与 5.56）方面都做得更好。两种 PDI 在减少受访者的注射频率、注射器和其他设备的共用以及无保护性行为率方面均表现出同等且显着的功效。还记录了 PDI 模型的另外两项改进：增强的后续机制使 PDI 的保留强度增加了一倍以上（达到约 75%），并明确表明吸毒者有能力在两种不同的预防信息体系中对新招募的人员进行教育，具体取决于新招募的人员是新的还是后续参与者。 (c) 2006 Elsevier B.V. 保留所有权利。
We report impact results on the first operating year of an HIV prevention field experiment for injection drug users (IDUs) in two cities in western Russia, comparing a Standard "peer-driven intervention" (PDI) in Bragino to a Simplified-PDI in Rybinsk. The PDI relies on IDUs to educate one another in the community about HIV prevention, and recruit peers for enhanced prevention services and education. In the Standard-PDI, IDU-recruiters are offered nominal monetary rewards for both recruiting peers and educating them in a body of prevention information. In the Simplified-PDI, IDU-recruiters are similarly asked to educate and recruit their peers, but the reward for recruiting is woven into their education efforts. This modification streamlined the model's operations and made it 50% less expensive to operate in respondent fees. The overarching research question is whether the modification in the PDI's reward structure affects the model's recruitment power and educational effectiveness. First year results indicate that both PDIs achieved high baseline recruitment rates, although the Standard-PDI out-performed the Simplified-PDI by approximately 35% (493 recruits versus 365 recruits, respectively). However, the IDU-recruiters in the Simplified-PDI did a significantly better job educating their recruits at both baseline (an average knowledge test score of 5.19 versus 4.07 on an 8-point scale) and at follow-up 6 months later (an average knowledge test score of 7.21 versus 5.56 on an 8-point scale). Both PDIs demonstrated about equal and significant efficacy in reducing respondents' injection frequency, the sharing of syringes and other equipment, and rates of unprotected sex. Two additional refinements in the PDI model were also documented: an enhanced follow-up mechanism more than doubled the PDI's retention strength (to approximately 75%), and clear demonstration that IDUs are capable of educating their recruits in two different bodies of prevention information, depending on whether the recruits are new or follow-up participants. (c) 2006 Elsevier B.V. All rights reserved.