Use of a peer leader intervention model to reduce needle-related risk behaviors among drug injectors in Ukraine

This study was designed to assess change in needle-related risks following interventions with injection drug users (IDUs) in the Crimea. Participants were recruited through street outreach by former IDUs in the cities of Simferopol and Nikolayev, Ukraine. The intervention was based on a social network model in which peer leaders were recruited and asked to bring in up to three members of their injecting network. Findings supported the feasibility of the intervention: peer leaders recruited an average of 2.4 network members; two-thirds attended at least four of the five training sessions; and a positive relationship was observed between greater session attendance by peer leaders and increased communication with network members about HIV prevention. Moreover, leaders who did not engage in high-risk behaviors at follow-up were much more likely to have had network members who did not engage in high-risk activities compared to leaders who continued high-risk behaviors.