Background Although Needle Exchange Programs (NEP) are a great tool in fighting HIV/AIDS and yielding a significant cost savings for intravenous drug users (IDU) the challenge of the programme remains the irregular uptake of services from the clients and attracting new clients. Contingency Management (CM) is widely known as an intervention that addresses behaviours concerns. It provides tangible rewards for clients to increase or decrease the frequency of concrete target behaviours. The programme hypothesised that using the reward system via CM might help better engage with the clients, ensure regular use of services and gain new clients.
Methods 80 NEP users were recruited and equally divided into two groups, the experimental and control one. Implementation phase was followed by: Development of CM protocol, identification of the desired behaviours that an IDU client should change and maintain, establishment of the reward mechanism and monitoring and evaluating outcomes.
Results In comparison with control group clients, participants of the CM group had higher rates (up to three fold) of daily attendance of NEP services. All of them have been tested for HIV and HVC in comparison with 35% of control groups, and one third of them brought their sexual partners to be tested. 15% have invited programme team (home visits) to discuss with their sexual partner/family members. In addition, was significantly increased the number of female IDUs who have been introduced to NEP by CM participants.
Conclusions CM approach indicates the need for using innovative interventions to attract and motivate IDUs clients in using on regular basis HR programmes, especially for hard to reach subgroups of IDUs, such as female drug users or IDUs sexual partners. Regular uptake of HR services implies reductions in injection-related drug-taking behaviours and therefore lesser risks for getting or transmitting HIV/HVB&C.
- contingency management
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