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International audience; Background: Harm reduction (HR) interventions are essential to reduce human immunodeficiency virus (HIV) and hepatitis C virus (HCV) transmission in people who inject drugs (PWID). Preliminary testing of the Individually Tailored Support and Education for Safer Injection (ITSESI) evidence-based educational intervention for PWID was performed in France in 2011. We created the Eurosider project to implement and evaluate ITSESI at a wider European level, with a view to its future pan-European diffusion.Methods: We performed a mixed-methods study involving quantitative (a 6-month before-after study with PWID) and qualitative (focus groups with field workers) components. The study was conducted in 2018-2019 with 307 eligible PWID participating in four existing HR programmes in Bulgaria, Greece, Portugal, and Romania. ITSESI consists in trained field workers observing PWID injection practices and providing an educational exchange. For the present study, PWID participants were allocated to either the control group (i.e., they continued receiving only the current HR services) or the intervention group (i.e., current HR services plus ITSESI). We used the RE-AIM QuEST framework to assess the effectiveness of ITSESI and its acceptability by field workers. Effectiveness was defined as a reduction in both syringe sharing - the highest HIV/HCV transmission risk practice - and in cutaneous abscesses. We used a multivariable mixed logit model to analyse both effectiveness outcomes and to provide adjusted odds ratios (aOR) and 95% confidence intervals (CI). Field workers' acceptability of the intervention was described using a thematic analysis of the qualitative data.Results: Of the 307 PWID, 55% received ITSESI. Syringe sharing and cutaneous abscesses decreased during follow-up in the intervention group (from 25 to 16% and from 27 to 14%, respectively). Reductions were smaller in the control group (from 29 to 24% and from 23 to 18%, respectively). The multivariable analyses confirmed the effect of the intervention on both of these outcomes (aOR [95% CI]: 0.38 [0.17, 0.85]) and (aOR [95% CI]: 0.38 [0.16, 0.90], respectively). Our qualitative data on acceptability showed the feasibility of involving field workers as proactive research partners in making ITSESI more accessible and acceptable across Europe.Conclusions: We demonstrated both the effectiveness of ITSESI in reducing syringe sharing and cutaneous abscesses in four European countries, and a high level of intervention acceptability by field workers. Our findings provide important insights into how ITSESI can be adapted for pan-European implementation.

This report is the ninth in the annual series reviewing behavioural data relevant to the transmission of human immunodeficiency virus (HIV), viral hepatitis and other sexually transmissible infections (STIs) in Australia. It examines behavioural data relevant to the prevention and treatment of these infections, for example, uptake of testing and antiretroviral therapy. It also includes data relating to the social aspects of treatment and care of those infected with hepatitis C virus and HIV, including those living with acquired immune deficiency syndrome (AIDS). This report does not include all research done by the National Centre in HIV Social Research (NCHSR), but concentrates on those data that enable assessment of trends over time and comparison between states., Monograph 1/2007

Monograph 3/2006

Monograph 3/2005

This study examines a significant gay 'subculture', that od sexual adventurism. We sought to understand how gay men made sense of their adventurous sex, the social context in which it was practised, and the HIV-related health risks associated with it. The objectives of the study were to: - map the social context in which sexual adventurism occurs - understand the ways in which gay men engage in a sexually adventurous subculture - investigate the sexual practices and drug use of gay men in the context of adventurous sexual sessions - identify the relationship between unsafe sex, drug use and sexual adventurism., Monograph 3/2004

Monograph 4/2004

Monograph 4/2003

The Melbourne Gay Community Periodic Survey is a cross-sectional survey of gay and homosexually active men recruited through a range of sites in the Melbourne metropolitan area. The project was funded by the Victorian Department of Human Services. The Periodic Survey provides a snapshot of sexual and HIV-related practices among gay and homosexually active men., Monograph 1/1998