Theme: Social Science & Policy Research Year: 2016
THE EFFICACY OF PSYCHOSOCIAL INTERVENTIONS TO REDUCE SEXUAL AND DRUG BLOOD BORNE VIRUS RISK BEHAVIOURS AMONG PEOPLE WHO INJECT DRUGS: A SYSTEMATIC REVIEW AND META-ANALYSIS
Gilchrist G1, Swan D1, Widyaratna K1, Marquez-Arrico JE2, Hughes L3, Mdege N4, Tirado-Munoz J5
1 National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, UK
2 Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Spain
3 School of Human and Health Sciences, University of Hudderfield, UK
4 Department of Health Sciences, Faculty of Science, University of York, UK
5 IMIM Hospital del Mar Medical Research Institute, Barcelona, Spain
Backgound: Preventing people who inject drugs (PWID) transmitting or becoming infected with blood borne viruses such as HIV, Hepatitis C and Hepatitis B is an important public health issue. Opiate substitution therapy (methadone or buprenorphine) and needle exchanges have reduced these viruses but psychosocial interventions could further prevent their spread. Aims: To determine the efficacy of psychosocial interventions (e.g. CBT, contingency management, skills training) in reducing sexual and drug risk behaviours among PWID compared to control interventions.
Methods: A systematic review was conducted and a meta-analysis performed, using a random effects model. Randomized control trials (RCTs) published during 2000- May 2015 in MEDLINE, PsycINFO, CINAHL, Cochrane Collaboration and Clinical trials were included.
Results: 31 and 25 RCTS were included in the systematic review and meta-analysis respectively. Psychosocial interventions were more efficacious in reducing any injecting risk behaviour (standardized mean difference (SMD) –0.29; 95% confidence interval (CI) –0.43, –0.15), sharing of needle/syringes (SMD –0.44; 95% CI –0.71, –0.17), sharing other injecting paraphernalia (SMD –0.21; 95% CI –0.33, –0.08) and unprotected sex (SMD –0.30; 95% CI –0.58, –0.02).
Conclusions: Psychosocial interventions are effective in reducing sexual and drug risk behaviours among PWID. Such interventions should be included with other harm reduction approaches (e.g. OST, needle/syringe exchange) to address blood borne virus transmission among PWID. Limitations include the heterogeneity of interventions.
Disclosure of Interest Statement: The authors declare that they have no conflicts of interest.Download abstract Download poster