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Preventing blood borne virus infection in people who inject drugs in the UK

People who inject drugs (PWID) are at risk of blood borne viruses (BBV) such as Hepatitis B, Hepatitis C and HIV as a result of sharing injecting equipment (needles and syringes, water, spoons, cotton etc) and unsafe sex. In the UK, around 33%-56% of PWID have Hepatitis C. Rates of HIV (0-1%) and Hepatitis B (6-18%) are much lower. Preventing PWID from getting or passing on these viruses is an important health issue. Interventions such as opiate substitution therapy (methadone or buprenorphine) and needle exchanges have reduced BBV in this population. There is however a potential to further prevent the spread of BBV through behavioural interventions such as individual or group brief or multi-session interventions led by peers or staff that teach PWID how to reduce risk behaviours.

The current project will develop an evidence based psychosocial intervention to reduce BBV and increase BBV transmission knowledge among PWID, and conduct a feasibility trial to evaluate this intervention against an information leaflet. The hope is that the findings from this feasibility trial will inform the future parameters of a large multisite RCT.

This is a 20 month mixed methods project with 6 complementary phases. Phases 1-3 will gather the information required to develop an evidence based intervention through: a systematic review of the current evidence (Phase 1); and qualitative methods to gain an understanding of PWIDs’ influences on behaviour and views on psychosocial interventions (Phase 2), and to solicit key stakeholders’ views on the delivery and effectiveness of psychosocial interventions (Phase 3). Intervention development will be Phase 4. The feasibility and acceptability of this intervention will be assessed in Phase 5, and finally in Phase 6, the results will inform the preparation for a future multisite trial in the UK.

The University of York is involved in Phases 1, 2, 5 and 6, including the cost-effectiveness component.