Title

Effects of a couple-based intervention to reduce risks for HIV, HCV, and STIs among drug-involved heterosexual couples in Kazakhstan: A randomized controlled trial

Keywords

HIV/AIDS, HCV, Injection Drug Use, Kazakhstan

Abstract

Objective

Project Renaissance is a randomized controlled trial of an HIV/HCV/STI prevention intervention conducted in Almaty, Kazakhstan. We hypothesized that couples assigned to the intervention of interest will have lower incidence of HIV, HCV, sexually transmitted infections (STI), rates of unprotected sex, and unsafe injection over the 12-month follow up period compared to those assigned to an attention control arm.

Design

A total of 300 couples (600 participants) where one or both partners reported injecting drugs in the past 90 days were randomized to one of two arms: (1) a five-session HIV/HCV/STI prevention intervention (Risk Reduction: RR), or (2) a five-session Wellness Promotion (WP) intervention.

Results

Over the 12-month follow up period, assignment to RR compared to WP significantly lowered the incidence of HCV infection by 69% (IRR=0.31, 95% CI=0.10 – 0.90, p=0.031). Although differences were not statistically significant, RR participants had a lower incidence of HIV infection by 51% (IRR=0.49, 95% CI=0.16 – 1.48, p=0.204) and any STI by 37% (IRR=0.63, 95%=0.21 – 1.93, p=0.418) than WP participants. RR participants reported significantly fewer numbers of unprotected vaginal sex acts with their study partners (IRR=0.58, 95% CI=0.36 – 0.93, p=0.024) and more consistent condom use (OR=2.30, 95% CI=1.33 – 4.00, p=0.003) over the entire follow-up period compared to WP participants.

Conclusion

Project Renaissance demonstrated a significant effect for biological and behavioral endpoints. Findings draw attention to an HIV/HCV/STI prevention intervention strategy that can be scaled up for drug-involved couples in harm reduction programs, drug treatment, and criminal justice settings.

Original Publication Citation

El-Bassel, N., Gilbert, L., Terlikbayeva, A., Beyrer, C., Wu, E., Chang, M., Hunt, T., Ismayilova, L., Shaw, S.A., Primbetova, S., Rozental, Y., Zhussupov, B., & Tukeyev, M. (2014). Effects of a couple-based intervention to reduce risks for HIV, HCV, and STIs among drug-involved heterosexual couples in Kazakhstan: A randomized controlled trial. JAIDS, 67(2), 196-203.

Document Type

Peer-Reviewed Article

Publication Date

2015-10-01

Publisher

Journal of Acquired immune Deficiency Syndrome

Language

English

College

Family, Home, and Social Sciences

Department

Social Work

University Standing at Time of Publication

Assistant Professor

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