The effectiveness of peer education interventions on HIV- and HBV-preventive behaviours in women with substance-related disorders: a cluster randomised control trial

Introduction
Substance-related disorders (SRDs) have become a problematic phenomenon in many countries, including Iran. Risky sexual behaviours are highly prevalent among people with SRDs. This study aimed to evaluate the effectiveness of a peer education program on preventive behaviours related to human immunodeficiency virus (HIV) and hepatitis B virus (HBV) in women with SRDs.

Material and methods
One hundred eligible female drug abusers from 10 drop-in centres located in Tehran were entered into the study using convenience sampling. The intervention included six training sessions. Sessions were held in small groups and conducted by peer educators. The primary topics discussed were problem-solving skills, and HIV/HBV disease-related information including testing, transmission, and prevention. All participants completed demographic and sexual function questionnaires prior to, one-, and three-months post-intervention.

Results
The results showed a significant decrease in the percentage of drug (96.00%, 75.55%, 73.52%, p = 0.001) and alcohol use (32.00%, 13.33%, 2.90%, p = 0.000) prior to sexual intercourse in the intervention group. Additionally, the number of sex acts under the influence of drugs and alcohol decreased significantly (p < 0.001). The number of sexual partners (p < 0.000) significantly declined, but total drug use indicated no change. We found increases in the percentage of women who reported having had a recent HIV test (p < 0.001) and in condom use (p < 0.001), but the control group showed no significant difference.

Conclusions
Based on current results, peer education programs can have a positive effect on high-risk sexual behaviours related to HIV and HBV in women with substance-related disorders. The potential influence of peers in health interventions should be given greater consideration.