Reducing HCV/HIV risks comparing two interventions

描述（由申请人提供）：背景：丙型肝炎病毒（HCV）感染目前是该国注射吸毒者（IDUs）的主要健康威胁。 迄今为止，很少有干预措施专门针对丙型肝炎病毒，虽然大量的干预工作针对人类免疫缺陷病毒（HIV）的传播。 这两种疾病都是通过类似的注射相关行为传播的，特别是共用针头和其他用具。 在这个应用程序中，我们建议测试两种干预措施，发现有效减少艾滋病毒相关的风险行为。 其中包括我们自1987年以来一直在丹佛使用的以个人为重点的街头外展干预，以及卡尔·拉特金博士在巴尔的摩开发的以网络为导向的同伴教育干预。 在这两种方法中，将招募和培训一批注射吸毒者，使他们成为社区中的丙型肝炎病毒/艾滋病毒预防专家。 这些专家，被称为“索引”科目，将被要求把他们的注入网络的两个成员的项目。 以个人为重点的干预将侧重于改变指数参与者的行为，而同伴干预将侧重于为指数参与者提供改变其网络规范所需的教育和技能。 该项目的目标是：1。 比较同伴网络干预与个体集中干预在增加索引和网络成员之间对HCV和HIV的知识方面的有效性; 2. 比较两种干预方法对指标人群和网络成员降低HCV/HIV相关风险的效果。 比较两种干预措施在提高自我效能以减少索引和网络成员中HCV和HIV风险相关行为方面的有效性。 总共750名注射吸毒者将被随机分配到两种干预措施之一。 其中一半将参加研究的同伴教育组，另一半将参加以个人为重点的干预。 将对250个网络进行检查，每组各一半，索引受试者将带来两名网络成员参与研究。 索引成员将被随机分配到两个干预组之一。 如果在同伴教育组中，指标受试者将接受同伴教育干预，包括为期三周的五次小组会议，重点是同伴教育。 还需要一次助推器会议。 在基线、6个月和12个月时，将评估两组网络成员的风险行为、自我效能和HCV/HIV知识。 在单独关注组中，索引受试者将在三周时间内接受五次单独的风险降低会议。 在基线、6个月和12个月时，所有受试者都需要接受HCV和HIV检测前和检测后咨询。

DESCRIPTION (provided by applicant): Background: Hepatitis C virus (HCV) infection is currently a major health threat among injection drug users (IDUs) in this country. To date, few interventions have specifically targeted HCV, although a great many intervention efforts have targeted human immunodeficiency virus (HIV) transmission. Both of these diseases are transmitted by similar injection-related behaviors, specifically sharing needles and other paraphernalia. In this application we propose to test two interventions found to be effective in reducing HIV-related risk behaviors. These include an individually focused street outreach intervention we have been using in Denver since 1987, and a network oriented peer education intervention developed in Baltimore by Carl Latkin, Ph.D. In both approaches, a cohort of IDUs will be recruited and trained to serve as HCV/HIV prevention experts in the community. These experts, referred to as "index" subjects, will be asked to bring to the project two members of their injecting network. The individually focused intervention will focus on changing the index participants' behavior, while the peer intervention will focus on providing index participants with the education and skills necessary to change the norms of their network. The aims of the project are: 1. To compare the effectiveness of a peer network intervention vs. an individually focused intervention in increasing knowledge about HCV and HIV among both index and network members; 2. To compare the two intervention approaches on both index and network members in reducing HCV/HIV-related risks; and 3. To compare the effectiveness of the two interventions in increasing self-efficacy to reduce HCV and HIV risk-related behaviors among index and network members. A total of 750 IDUs will be randomly assigned to one of the two interventions. Half of these will participate in the peer education arm of the study and half will participate in the individually focused intervention. Two hundred and fifty networks will be examined, again with half in each arm. Index subjects will bring in two network members to participate in the study. Index members will then be randomly assigned to one of the two intervention arms. If in the peer education arm, index subjects will undergo the peer education intervention, consisting of five group sessions focusing on peer education over a period of three weeks. A booster session will also be required. Network members in both arms will be assessed for risk behaviors, self-efficacy, and HCV/HIV knowledge at baseline, six months and 12 months. In the individually- focused arm, index subjects will undergo five individual risk reduction sessions over three weeks time. HCV and HIV pre- and post-test counseling will be required of all subjects at baseline, six months and 12 months.