Development, description, and acceptability of a small-group, behavioral intervention to prevent HIV and hepatitis C virus Infections among young adult injection drug users

Young injection drug users (IDUs) who are not infected with HIV or hepatitis C virus are at great risk of acquiring one or both of these infections through their sexual or injection behaviors. We describe the development of a behavioral intervention designed to decrease sexual and injection risk behaviors among young IDUs. The intervention was developed through a dynamic and iterative process that involved extensive development activities, focus groups with the target population to pilot individual activities and intervention sessions, and later, pilot testing of the entire intervention. The six-session intervention that emerged from the development process relied on both social-cognitive theories and peer influence models. We also designed a control intervention, trained facilitators to deliver the interventions, and conducted quality assurance of intervention delivery. To better understand intervention trial findings, we asked participants about their intervention experiences and examined potential contamination across arms. Both interventions were delivered with high fidelity and participants in both groups reported positive experiences. More perceived impact was reported for injection risk behaviors than for sexual risk behaviors among participants in the intervention arm. Minimal evidence of contamination was found. Lessons learned can help future researchers to develop stronger interventions for this high-need population.