Developing a peer education model designed to reduce HIV risk among methamphetamine injection drug users: Lessons from a feasibility study

Methamphetamine injectors are at high risk for HIV and HCV. Syringe exchange programs (SEPs) and other health and social services are available, but some methamphetamine injectors do not participate, relying instead on other injectors to attend the SEP and deliver clean syringes and other supplies to them. These “hidden recipients” do not, however, receive other needed risk reduction interventions, medical screenings and treatment, or ancillary health and social services from the SEP. In this presentation, we will discuss the results from a formative feasibility study undertaken to inform the development of an innovative program that uses secondary exchangers – methamphetamine injectors who frequent our SEP and who provide syringes from the exchange to others – as peer educators to deliver HIV risk reduction messages, condoms, and service referrals to methamphetamine injecting recipients who do not regularly attend an SEP site themselves. Results include a description of the: 1) population of methamphetamine injectors who frequent the SEP and exchange for others as well as their “hidden recipient” networks; 2) barriers to accessing health and social services (e.g., fear of arrest, stigma, lack of transportation); and 3) intervention refinements suggested by methamphetamine injectors participating in the focus groups and key informant interviews. These results indicate that it is feasible to reach into hidden networks of methamphetamine injectors by utilizing peers to deliver quality intervention services. Preliminary intervention data from the pilot study will also be presented.