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Meta-Analysis
. 2006 Sep;31(2):163-71.
doi: 10.1016/j.jsat.2006.04.002. Epub 2006 Jul 13.

Behavioral HIV risk reduction among people who inject drugs: meta-analytic evidence of efficacy

Michael M Copenhaver  1 , Blair T Johnson, I-Ching Lee, Jennifer J Harman, Michael P Carey; SHARP Research Team
Affiliations
Meta-Analysis

Behavioral HIV risk reduction among people who inject drugs: meta-analytic evidence of efficacy

Michael M Copenhaver et al. J Subst Abuse Treat. 2006 Sep.

Abstract

We conducted a meta-analysis of randomized controlled trials (RCTs) to evaluate behavioral HIV risk reduction interventions targeting people who inject drugs. We included 37 RCTs evaluating 49 independent HIV risk reduction interventions with 10,190 participants. Compared to controls, intervention participants reduced injection drug use (IDU) and non-IDU, increased drug treatment entry, increased condom use, and decreased trading sex for drugs. Interventions were more successful at reducing IDU when participants were non-Caucasians, when content focused equivalently on drug-related and sex-related risks, and when content included interpersonal skills training specific for safer needle use. Condom use outcomes improved when two intervention facilitators were used instead of one. IDU outcomes did not decay, but condom use outcomes did. Behavioral interventions reduce risk behaviors among people who inject drugs, especially when interventions target both drug risk and sexual risk behaviors, and when they include certain behavioral skills components. Implications for future interventions are presented.

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Figures

Figure 1
Figure 1
Selection process for study inclusion in the meta-analysis
Figure 2
Figure 2
Forest plots for injection-drug use (upper panel) and condom use (lower panel) effect sizes, in which delta points to the right of the zero point reflect risk-reduction and those to the left reflect risk increase, relative to the control group. Zero values indicate exactly no difference between the two groups. The symbols for statistically significant effects are filled whereas those that are not significant are open. The size of the delta symbol for each effect size reflects its weight in the analyses. The confidence interval for the mean effect size is displayed by the width of its diamond.
Figure 2
Figure 2
Forest plots for injection-drug use (upper panel) and condom use (lower panel) effect sizes, in which delta points to the right of the zero point reflect risk-reduction and those to the left reflect risk increase, relative to the control group. Zero values indicate exactly no difference between the two groups. The symbols for statistically significant effects are filled whereas those that are not significant are open. The size of the delta symbol for each effect size reflects its weight in the analyses. The confidence interval for the mean effect size is displayed by the width of its diamond.
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