Outcome evaluation of a "common factors" approach to develop culturally tailored HIV prevention interventions for people who inject drugs

Drug Alcohol Depend. 2019 Jun 1:199:18-26. doi: 10.1016/j.drugalcdep.2019.02.015. Epub 2019 Apr 6.

Abstract

Background: Current models of HIV prevention intervention dissemination involve packaging interventions developed in one context and training providers to implement that specific intervention with fidelity. Providers rarely implement these programs with fidelity due to perceived incompatibility, resource constraints, and preference for locally-generated solutions. Moreover, such interventions may not reflect local drug markets and drug use practices that contribute to HIV risk.

Purpose: This paper examines whether provider-developed interventions based on common factors of effective, evidence-based behavioral interventions led to reduction in drug-related HIV risk behaviors at four study sites in Ukraine.

Methods: We trained staff from eight nongovernmental organizations (NGOs) to develop HIV prevention interventions based on a common factors approach. We then selected four NGOs to participate in an outcome evaluation. Each NGO conducted its intervention for at least N = 130 participants, with baseline and 3-month follow-up assessments.

Results: At three sites, we observed reductions in the prevalence of both any risk in drug acquisition and any risk in drug injection. At the fourth site, prevalence of any risk in drug injection decreased substantially, but the prevalence of any risk in drug acquisition essentially stayed unchanged.

Conclusions: The common factors approach has some evidence of efficacy in implementation, but further research is needed to assess its effectiveness in reducing HIV risk behaviors and transmission. Behavioral interventions to reduce HIV risk developed using the common factors approach could become an important part of the HIV response in low resource settings where capacity building remains a high priority.

Keywords: Common factors; Drug use; HIV prevention; Implementation science; Ukraine.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Culturally Competent Care / methods*
  • Culturally Competent Care / trends
  • Female
  • Follow-Up Studies
  • HIV Infections / ethnology*
  • HIV Infections / prevention & control*
  • Humans
  • Male
  • Needle Sharing / adverse effects
  • Needle Sharing / trends
  • Organizations / trends
  • Outcome Assessment, Health Care / methods*
  • Outcome Assessment, Health Care / trends
  • Risk Factors
  • Substance Abuse, Intravenous / ethnology*
  • Substance Abuse, Intravenous / prevention & control*
  • Ukraine / ethnology
  • Young Adult