Effects of Motivational Interviewing on Risky Injecting Practices Among Injecting Drug Users (IDUs)

Study Overview
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Brief Summary
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The purpose of this study is to evaluate the effects of a brief motivational intervention in reducing risky injection practices among injecting drug users (IDUs). The investigators hypothesis is that motivational intervention will be more effective than educational intervention in reducing risky injection practices among IDUs.

Detailed Description
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Injecting drug users (IDUs) are among the most vulnerable populations at risk to contract human immunodeficiency virus (HIV) and hepatitis C virus (HCV). Among Canadian cities, Montreal holds one of the higher HIV and HCV contraction rates in the IDU population. Results from SurvUDI, a population survey among IDUs conducted in the province of Quebec (Canada), show that in Montreal 18% of IDUs are infected with HIV and 67% are infected with HCV. The cornerstone of HIV and HCV prevention strategies is to give information on safe injection practices and to make available sterile syringes and other injection equipment. However, the SurvUDI survey reveals that a large proportion of IDUs recruited in community programs offering sterile injection equipment and information on safe injection practices are still sharing needles with other IDUs. Indeed, it seems that information dissemination and distribution of sterile injection equipment are not sufficient in order to control the HIV and HCV epidemic among IDUs. As a matter of fact, it is obvious that complementary interventions such as behavioural interventions are required. Motivational interviewing is an intervention technique centered on the individual. It aims to enhance intrinsic motivation to change behavior by helping the individual to resolve ambivalence. The scientific literature indicates that brief motivational intervention is a significantly effective intervention in order to reduce drug use problems and other related health problems. Furthermore, motivational intervention is well adapted for IDUs' resistance to change and their difficulties related with involvement in long-term therapeutic process. The present study's hypothesis is that IDUs assigned to the experimental group (brief motivational intervention) will present a greater diminution of their risky injection practices in comparison with IDUs assigned to the control group (educational intervention).

Official Title
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Effects of a Brief Motivational Intervention on Risky Injection Practices Among Injecting Drug Users

Conditions
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HIV, Hepatitis C

Intervention / Treatment
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* Behavioral: Motivational interviewing
* Behavioral: Educational intervention


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: In the last month, at least one cocaine injection In the last month, at least one injection with a syringe or another piece of injection equipment that has been used by someone else 16 years old or more French speaking Being able to give informed consent

Ages Eligible for Study
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Minimum Age: 16 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Motivational interviewing<br>Motivational interviewing is a client-centered, directive method for enhancing intrinsic motivation to change by exploring and resolving ambivalence (Miller & Rollnick. 1993). This 45 minutes individual motivational intervention focuses on risky injection practices. | Behavioral: Motivational interviewing<br>* Motivational interviewing is a client-centered, directive method for enhancing intrinsic motivation to change by exploring and resolving ambivalence (Miller & Rollnick. 1993). This 45 minutes individual motivational intervention focuses on risky injection practices.<br>|
| Active Comparator: Educational intervention<br>The educational intervention is a 45 minutes individual intervention based on a document written by the Québec ministry of health (Québec, Canada). The aim is to inform participants about safe injection practices and to show them how to use sterile injection equipment. | Behavioral: Educational intervention<br>* The educational intervention is a 45 minutes individual intervention based on a document written by the Québec ministry of health (Québec, Canada). The aim is to inform participants about safe injection practices and to show them how to use sterile injection equipment.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Risky injecting practices |  | 3 and 6 month follow-ups | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Stages of change for risky injecting practices (adapted from Prochaska & DiClemente) |  | 3 and 6 month follow-ups | 
| Drug use (including injecting frequency) |  | 3 and 6 months follow-ups | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Vulnerable Populations, Injecting drug users, IDU, Risky injecting practices, Psychotherapy, brief, Motivational interviewing, Educational activities, Clinical trial, Risk behavior, risk reduction behavior