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      DOES IT WORK? -a randomized controlled trial to test the efficacy of HCV and HIV-related education on drug users in MMT, China

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          Abstract

          Background

          HCV (Hepatitis C virus) is a prevalent chronic disease with potentially deadly consequences, especially for drug users. However, there are no special HCV or HIV (human immunodeficiency virus)-related intervention programs that are tailored for drug users in China; to fill this gap, the purpose of this study was to explore HCV and HIV-related knowledge among drug users in MMT (methadone maintenance treatment) sites of China and to investigate the effectiveness of HCV and HIV-related education for improving the knowledge of IDUs (injection drug users) and their awareness of infection.

          Methods

          The study was a randomized cluster controlled trial that compared a usual care group to a usual care plus HCV/HIV-REP (HCV/HIV-Reduction Education Program) group with a 24-week follow-up. The self-designed questionnaires, the HCV- and HIV-related knowledge questionnaire and the HIV/HCV infection awareness questionnaire, were used to collect the data. Four MMT clinics were selected for this project; two MMT clinics were randomly assigned to the research group, with subjects receiving their usual care plus HCV/HIV-REP, and the remaining two MMT clinics were the control group, with subjects receiving their usual care over 12 weeks. Sixty patients were recruited from each MMT clinic. A total of 240 patients were recruited. Follow-up studies were conducted at the end of the 12th week and the 24th week after the intervention.

          Results

          At baseline, the mean score (out of 20 possible correct answers) for HCV knowledge among the patients in the group receiving the intervention was 6.51 (SD = 3.5), and it was 20.57 (SD = 6.54) for HIV knowledge (out of 45 correct answers) and 8.35 (SD = 2.8) for HIV/HCV infection awareness (out of 20 correct answers). At the 12-week and 24-week follow-up assessments, the research group showed a greater increase in HCV−/HIV-related knowledge (group × time effect, F = 37.444/11.281, P < 0.05) but no difference in their HIV/HCV infection awareness (group × time effect, F = 2.056, P > 0.05).

          Conclusion

          An MMT-based HCV/HIV intervention program could be used to improve patient knowledge of HCV and HIV prevention, but more effort should be devoted to HIV/HCV infection awareness.

          Trial registration

          Protocols for this study were approved by institution review board (IRB) of Shanghai Mental Health Center (IRB:2009036), and registered in U.S national institutes of health (http://www.clinicaltrials.gov, NCT01647191). Registered 23 July 2012.

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          Most cited references22

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          Hepatitis C treatment access and uptake for people who inject drugs: a review mapping the role of social factors

          Background Evidence documents successful hepatitis C virus (HCV) treatment outcomes for people who inject drugs (PWID) and interest in HCV treatment among this population. Maximising HCV treatment for PWID can be an effective HCV preventative measure. Yet HCV treatment among PWID remains suboptimal. This review seeks to map social factors mediating HCV treatment access. Method We undertook a review of the social science and public health literature pertaining to HCV treatment for PWID, with a focus on barriers to treatment access, uptake and completion. Medline and Scopus databases were searched, supplemented by manual and grey literature searches. A two step search was taken, with the first step pertaining to literature on HCV treatment for PWID and the second focusing on social structural factors. In total, 596 references were screened, with 165 articles and reports selected to inform the review. Results Clinical and individual level barriers to HCV treatment among PWID are well evidenced. These include patient and provider concerns regarding co-morbidities, adherence, and side effect management. Social factors affecting treatment access are less well evidenced. In attempting to map these, key barriers fall into the following domains: social stigma, housing, criminalisation, health care systems, and gender. Key facilitating factors to treatment access include: combination intervention approaches encompassing social as well as biomedical interventions, low threshold access to opiate substitution therapy, and integrated delivery of multidisciplinary care. Conclusion Combination intervention approaches need to encompass social interventions in relation to housing, stigma reduction and systemic changes in policy and health care delivery. Future research needs to better delineate social factors affecting treatment access.
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            Information-motivation-behavioral skills model-based HIV risk behavior change intervention for inner-city high school youth.

            This study assessed the effects of 3 theoretically grounded, school-based HIV prevention interventions on inner-city minority high school students' levels of HIV prevention information, motivation, behavioral skills, and behavior. It involved a quasi-experimental controlled trial comparing classroom-based, peer-based, and combined classroom- and peer-based HIV prevention interventions with a standard-of-care control condition in 4 urban high schools (N = 1,532, primarily 9th-grade students). At 12 months postintervention, the classroom-based intervention resulted in sustained changes in HIV prevention behavior. This article discusses why both of the interventions involving peers were less effective than the classroom-based intervention at the 12-month follow-up and, more generally, suggests a set of possible limiting conditions for the efficacy of peer-based interventions.
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              Epidemiology of Hepatitis C Virus (HCV) Infection

              Hepatitis C virus remains a large health care burden to the world. Incidence rates across the world fluctuate and are difficult to calculate given the asymptomatic, often latent nature of the disease prior to clinical presentation. Prevalence rates across the world have changed as well with more countries aware of transfusion-related hepatitis C and more and more evidence supporting intravenous drug use as the leading risk factor of spread of the virus. This article reviews current hepatitis C virus prevalence and genotype data and examines the different risk factors associated with the virus.
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                Author and article information

                Contributors
                jingying_zhang77@163.com
                zhbinli@163.com
                403474162@qq.com
                13621690625@126.com
                simone72@163.com
                358052934@qq.com
                514422876@qq.com
                86-18017311220 , dujiangdou@163.com
                86-18017311220 , drminzhao@gmail.com
                Journal
                BMC Infect Dis
                BMC Infect. Dis
                BMC Infectious Diseases
                BioMed Central (London )
                1471-2334
                5 September 2019
                5 September 2019
                2019
                : 19
                : 774
                Affiliations
                [1 ]ISNI 0000 0004 0368 8293, GRID grid.16821.3c, Collaborative Innovation Center for Brain Science, Shanghai Mental Health Center, , Shanghai Jiao Tong University School of Medicine, ; 600 South Wanping Road, Shanghai, 200030 China
                [2 ]Mental Health Center of Jiading District in Shanghai, Shanghai, China
                [3 ]Mental Health Center of Yangpu District in Shanghai, Shanghai, China
                [4 ]Mental Health Center of Hongkou District in Shanghai, Shanghai, China
                [5 ]Mental Health Center of Xuhui District in Shanghai, Shanghai, China
                [6 ]Songnan Community Health Service Center, Baoshan District, Shanghai, China
                [7 ]ISNI 0000 0004 1782 6212, GRID grid.415630.5, Shanghai Key Laboratory of Psychotic Disorders, ; Shanghai, China
                Author information
                http://orcid.org/0000-0003-4014-1070
                Article
                4421
                10.1186/s12879-019-4421-5
                6727322
                31488064
                9626a706-ac81-494e-b40e-21ff672e6db0
                © The Author(s). 2019

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 17 May 2018
                : 28 August 2019
                Funding
                Funded by: Shanghai Municipal Education Commission—Gaofeng Clinical Medicine Grant Support
                Award ID: 20152235
                Award Recipient :
                Funded by: National Key R&D Program of China
                Award ID: 2017YFC1310400
                Award Recipient :
                Funded by: National Natural Science Foundation of China
                Award ID: U1502228
                Award ID: 81771436
                Award Recipient :
                Funded by: Shanghai Municipal Health and Family Planning Commission joint research project
                Award ID: 2014ZYJB0002
                Award Recipient :
                Funded by: Shanghai Key Laboratory of Psychotic Disorders
                Award ID: 13DZ2260500
                Award Recipient :
                Funded by: Program of Shanghai Academic Research Leader
                Award ID: 17XD1403300
                Award Recipient :
                Funded by: key subject of Shanghai Municipal Health and Family Planning Commission(Psychiatry)
                Award ID: 2017ZZ02021
                Award Recipient :
                Funded by: Key Subject Construction of Jiading District Mental Health
                Award ID: JDYXZDZK-3
                Award Recipient :
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2019

                Infectious disease & Microbiology
                hcv,hiv,drug users,mmt,knowledge,infection awareness
                Infectious disease & Microbiology
                hcv, hiv, drug users, mmt, knowledge, infection awareness

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