Implementing an Updated “Break the Cycle” Intervention to Reduce Initiating Persons into Injecting Drug Use in an Eastern European and a US “opioid epidemic” Setting

Don Des Jarlais, Anneli Uuskula, Ave Talu, David M. Barnes, Mait Raag, Kamyar Arasteh, Greete Org, Donna Demarest, Jonathan Feelemyer, Hayley Berg, Susan Tross

Research output: Contribution to journalArticle

Abstract

We tested the hypothesis that an updated “Break the Cycle” (BtC) intervention, based in social cognitive theory and motivational interviewing, would reduce the likelihood that current persons who inject drugs (PWID) would assist persons who do not inject drugs (non-PWID) with first injections in Tallinn, Estonia and Staten Island, New York City. 402 PWID were recruited, a baseline interview covering demographics, drug use, and assisting non-PWID with first drug injections was administered, followed by BtC intervention. 296 follow-up interviews were conducted 6 months post-intervention. Percentages assisting with first injections declined from 4.7 to 1.3% (73% reduction) in Tallinn (p < 0.02), and from 15 to 6% (60% reduction) in Staten Island (p < 0.05). Persons assisted with first injections declined from 11 to 3 in Tallinn (p = 0.02) and from 32 to 13 in Staten Island. (p = 0.024). Further implementation research on BtC interventions is urgently needed where injecting drug use is driving HIV/HCV epidemics and areas experiencing opioid epidemics.

Original languageEnglish (US)
Pages (from-to)2304-2314
Number of pages11
JournalAIDS and Behavior
Volume23
Issue number9
DOIs
StatePublished - Sep 1 2019

Keywords

  • Break the cycle
  • First injection
  • HIV
  • Initiation
  • Injecting drug use
  • Opioid epidemic

ASJC Scopus subject areas

  • Social Psychology
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

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