A peer-education intervention to reduce injection risk behaviors for HIV and hepatitis C virus infection in young injection drug users

Richard S. Garfein, Elizabeth T. Golub, Alan E. Greenberg, Holly Hagan, Debra L. Hanson, Sharon M. Hudson, Farzana Kapadia, Mary H. Latka, Lawrence J. Ouellet, David W. Purcell, Steffanie A. Strathdee, Hanne Thiede

Research output: Contribution to journalArticle


OBJECTIVES: To evaluate whether a behavioral intervention, which taught peer education skills, could reduce injection and sexual risk behaviors associated with primary HIV and hepatitis C virus infection (HCV) among young injection drug users (IDU). DESIGN: We conducted a randomized controlled trial involving HIV and HCV antibody-negative IDU, aged 15-30 years, recruited in five United States cities. A six-session, small-group, cognitive behavioral, skills-building intervention in which participants were taught peer education skills (n = 431) was compared with a time-equivalent attention control (n = 423). Baseline visits included interviews for sociodemographic, psychosocial, and behavioral factors during the previous 3 months; HIV and HCV antibody testing; and pre/posttest counselling. Procedures were repeated 3 and 6 months postintervention. RESULTS: The intervention produced a 29% greater decline in overall injection risk 6 months postintervention relative to the control [proportional odds ratio 0.71; 95% confidence limit (CL) 0.52, 0.97], and a 76% decrease compared with baseline. Decreases were also observed for sexual risk behaviors, but they did not differ by trial arm. Overall HCV infection incidence (18.4/100 person-years) did not differ significantly across trial arms (relative risk 1.15; 95% CL 0.72, 1.82). No HIV seroconversions were observed. CONCLUSION: Interventions providing information, enhancing risk-reduction skills, and motivating behavior change through peer education training can reduce injection risk behaviors, although risk elimination might be necessary to prevent HCV transmission.

Original languageEnglish (US)
Pages (from-to)1923-1932
Number of pages10
Issue number14
StatePublished - Sep 1 2007



  • HIV
  • Hepatitis C virus
  • Injection drug use
  • Peer education
  • Randomized controlled trial
  • Young adult

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Infectious Diseases

Cite this

Garfein, R. S., Golub, E. T., Greenberg, A. E., Hagan, H., Hanson, D. L., Hudson, S. M., Kapadia, F., Latka, M. H., Ouellet, L. J., Purcell, D. W., Strathdee, S. A., & Thiede, H. (2007). A peer-education intervention to reduce injection risk behaviors for HIV and hepatitis C virus infection in young injection drug users. AIDS, 21(14), 1923-1932. https://doi.org/10.1097/QAD.0b013e32823f9066