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Peer-education intervention to reduce injection risk behaviors benefits high-risk young injection drug users: a latent transition analysis of the CIDUS 3/DUIT study.

Mackesy-Amiti ME, Finnegan L, Ouellet LJ, Golub ET, Hagan H, Hudson SM, Latka MH, Garfein RS - AIDS Behav (2013)

Bottom Line: Applying categorical latent variable analysis (mixture modeling) to baseline injection risk behavior data, we identified four distinct classes of injection-related HIV/HCV risk: low risk, non-syringe equipment-sharing, moderate-risk syringe-sharing, and high-risk syringe-sharing.Adjusting for gender, age, and race/ethnicity, a significant intervention effect was found only for the high-risk class.Young IDU who exhibited high-risk behavior at baseline were 90% more likely to be in the low-risk class at follow-up after the PEI intervention, compared to the control group.

View Article: PubMed Central - PubMed

Affiliation: Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, IL, USA. mmamiti@uic.edu

ABSTRACT
We analyzed data from a large randomized HIV/HCV prevention intervention trial with young injection drug users (IDUs) conducted in five U.S. cities. The trial compared a peer education intervention (PEI) with a time-matched, attention control group. Applying categorical latent variable analysis (mixture modeling) to baseline injection risk behavior data, we identified four distinct classes of injection-related HIV/HCV risk: low risk, non-syringe equipment-sharing, moderate-risk syringe-sharing, and high-risk syringe-sharing. The trial participation rate did not vary across classes. We conducted a latent transition analysis using trial baseline and 6-month follow-up data, to test the effect of the intervention on transitions to the low-risk class at follow-up. Adjusting for gender, age, and race/ethnicity, a significant intervention effect was found only for the high-risk class. Young IDU who exhibited high-risk behavior at baseline were 90% more likely to be in the low-risk class at follow-up after the PEI intervention, compared to the control group.

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Goodness of fit measures for latent class models
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Fig1: Goodness of fit measures for latent class models

Mentions: Based on model fit indices and log-likelihood change (see Fig. 1), the four-class model was clearly better than the three-class model, while the five-class model resulted in a relatively small improvement over the four-class model. Although the bootstrap likelihood ratio test indicated that the five-class model resulted in a significant improvement in fit (p < 0.0001), the additional class extracted comprised <10 % of the sample and we were not convinced that it contributed substantively to the model. The four-class model had very good classification quality (Entropy = 0.899), and the average latent class probabilities for most likely latent class membership ranged from 0.926 to 0.966. Based on the fit indices as well as conceptual considerations, we proceeded with the four-class model.Fig. 1


Peer-education intervention to reduce injection risk behaviors benefits high-risk young injection drug users: a latent transition analysis of the CIDUS 3/DUIT study.

Mackesy-Amiti ME, Finnegan L, Ouellet LJ, Golub ET, Hagan H, Hudson SM, Latka MH, Garfein RS - AIDS Behav (2013)

Goodness of fit measures for latent class models
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3672505&req=5

Fig1: Goodness of fit measures for latent class models
Mentions: Based on model fit indices and log-likelihood change (see Fig. 1), the four-class model was clearly better than the three-class model, while the five-class model resulted in a relatively small improvement over the four-class model. Although the bootstrap likelihood ratio test indicated that the five-class model resulted in a significant improvement in fit (p < 0.0001), the additional class extracted comprised <10 % of the sample and we were not convinced that it contributed substantively to the model. The four-class model had very good classification quality (Entropy = 0.899), and the average latent class probabilities for most likely latent class membership ranged from 0.926 to 0.966. Based on the fit indices as well as conceptual considerations, we proceeded with the four-class model.Fig. 1

Bottom Line: Applying categorical latent variable analysis (mixture modeling) to baseline injection risk behavior data, we identified four distinct classes of injection-related HIV/HCV risk: low risk, non-syringe equipment-sharing, moderate-risk syringe-sharing, and high-risk syringe-sharing.Adjusting for gender, age, and race/ethnicity, a significant intervention effect was found only for the high-risk class.Young IDU who exhibited high-risk behavior at baseline were 90% more likely to be in the low-risk class at follow-up after the PEI intervention, compared to the control group.

View Article: PubMed Central - PubMed

Affiliation: Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, IL, USA. mmamiti@uic.edu

ABSTRACT
We analyzed data from a large randomized HIV/HCV prevention intervention trial with young injection drug users (IDUs) conducted in five U.S. cities. The trial compared a peer education intervention (PEI) with a time-matched, attention control group. Applying categorical latent variable analysis (mixture modeling) to baseline injection risk behavior data, we identified four distinct classes of injection-related HIV/HCV risk: low risk, non-syringe equipment-sharing, moderate-risk syringe-sharing, and high-risk syringe-sharing. The trial participation rate did not vary across classes. We conducted a latent transition analysis using trial baseline and 6-month follow-up data, to test the effect of the intervention on transitions to the low-risk class at follow-up. Adjusting for gender, age, and race/ethnicity, a significant intervention effect was found only for the high-risk class. Young IDU who exhibited high-risk behavior at baseline were 90% more likely to be in the low-risk class at follow-up after the PEI intervention, compared to the control group.

Show MeSH