MASLIHAT HIV Prevention Intervention Reduced Sexually Transmitted Infections Among Male Tajik Migrants Who Inject Drugs in Moscow

Abstract

AbstractObjectivesTajik male labour migrants who inject drugs while working in Moscow are at high risk of acquiring HIV and sexually transmitted infections (STIs) that compromise their health and potentially that of their sexual partners. In a cluster-randomized controlled trial, the “Migrants’ Approached Self-Learning Intervention in HIV/AIDS for Tajiks” (MASLIHAT) reduced intervention participants’ sexual risk behaviour including condomless sex, condomless sex with female sex workers (CS/FSW), and multiple sexual partners. This analysis investigates if the observed change in sexual risk behaviors due to the intervention translated into lower incidence of STIs among participants over 12-month follow-up.MethodsThe MASLIHAT intervention was tested in a cluster-randomized controlled trial with sites assigned to either the MASLIHAT intervention or comparison health education training (TANSIHAT). Participants and network members (n=420) were interviewed at baseline and 3-month intervals for one year to assess HIV/STI sex and drug risk behaviour. Focusing solely on STIs in our current analysis, we conducted mixed effects robust Poisson regression analyses to test for differences between conditions in self-reported STIs during 12 months of follow-up, and to test the contribution of sexual risk behaviours to STI acquisition. Structural equation modelling investigated sexual behaviours as possibly mediating the observed differences in STI acquisition between the two conditions.ResultsParticipants in the MASLIHAT condition were significantly less likely to report an STI during follow-up (IRR=0.27, 95% CI 0.13-0.58). Of the 3 sexual risk behaviours of interest, only CS/FSW was significantly associated with STI acquisition (IRR=3.30, 95% CI 1.57-3.93). Adjusting for CS/FSW, the effect of MASLIHAT intervention participation was reduced (IRR=0.37, 95% CI 0.17-0.84), signalling possible mediation. Structural equation modelling indicated that the intervention’s effect on STI incidence was mediated by reductions among MASLIHAT participants in CS/FSW.ConclusionsThe MASLIHAT peer-education intervention reduced the incidence of STIs among Tajik labour migrants through reduced CS/FSW.