Table 1.

Documents included in the literature review

Author	Year	Study type	Country	Aims	Results/outcomes
Challenges and barriers involving highly stigmatized populations in policy making decisions
Bryant et al.	2008	Qualitative research	Australia	To describe beliefs about consumer participation in drug treatment services and perceived barriers to consumer participation	The majority of consumers and providers believed in consumer participation; barriers to consumer participation included opinions that it is not the consumers' place to take part, and the lack of interest and skills to participate
Fischer & Neale	2008	Qualitative research	Scotland, England	To explore challenges in the involvement of illicit drug users in the decisions about their treatment	Challenges to involving drug users in treatment decisions include lack of financial resources, communication between professionals and clients, and lack of investment in education, training and skills
Halloran et al.	1996	Pilot project evaluation	USA	To report on the development, implementation and evaluation of Project LEAP, a psychoeducational intervention, to increase participation of PLWHA	Participation from organizations increased from an average of 0.5 organizations at baseline to 2.3 at follow-up; increase in self-esteem, self-confidence, and knowledge were seen in the organizations
Roy & Cain	2001	Participatory action research	Canada	To examine the barriers and obstacles to meaningful involvement of PLWHA	Stereotyping of PLWHA, fear of losing anonymity, usefulness of PLWHA, power imbalances, health concerns are among the barriers that limit the involvement of PLWHA in the development of policies and delivery of services
Travers et al.	2008	Cross-sectional	Canada	To examine barriers and facilitating factors to the greater involvement of PLWHA in community-based research	Challenges to involving PLWHA include HIV-related stigma, health-related challenges, mistrust, and credibility of PLWHA; facilitating factors include training opportunities, financial compensation, building trust
Success in programs and interventions involving PWUD
Booth et al.	2009	Intervention study	Ukraine	To investigate changes in needle- related risks among IDU following peer leader interventions	Peer leaders significantly reduced needle risk behaviors at 6 months follow-up compared to baseline; findings suggest that peer leader intervention approach may be effective in reducing HIV risk behaviors among IDU in Ukraine
Broadhead et al.	1998	Intervention study	USA	To compare the TOI with a PDI in the context of HIV prevention efforts	Both interventions significantly reduced HIV risk behaviors; PDI reached a larger and more ethnically/geographically diverse population of IDU at a lower expense than TOI
Canadian Public Health Association	2005	Report	Canada	To lay out the ideal response to HIV/AIDS in Canada	Encourages sharing of responsibilities and increasing partnerships to make more effective use of our knowledge, skills and resources
Crofts & Herkt	1995	Literature review	Australia	To review the literature on the histories and impact of user groups in Australia	The role of user groups in Australia is important to the government for preventing further transmission of HIV among IDU and engagement with the groups should continue
Garfein et al.	2007	Randomized control trial	USA	To investigate whether a peer-education intervention can reduce injection and sexual risk behaviors associated with HIV and Hepatitis C in young IDU	The peer intervention reduced injection risk behaviors among young IDU by 29% overall at 6 months postintervention compared to control and 76% reduction compared to baseline; Sexual risk behaviors were also decreased postintervention
Hayashi et al.	2010	Cohort study	Canada	To evaluate a peer-run outreach-based syringe exchange program by VANDU called the Alley Patrol	The Alley Patrol was successful in reaching a higher risk group of IDU and was significantly associated with lower levels of needle reuse (AOR=0.65)
Latkin et al.	2003	Intervention study	USA	To investigate whether a network-oriented peer outreach intervention is associated with HIV prevention among drug users	In the experimental group, participants were 3 times more likely to report reduction in injection risk behavior and 4 times more likely to report increased condom use than controls; peer outreach strategies may be useful in reducing HIV risk behaviors in drug using communities
Purcell et al.	2007	Intervention study	USA	To investigate the efficacy of a peerHIV prevention program with PWUD through a project called the Risk Avoidance Partnership* project	Participants reported significant reductions of injection and sexual risk behaviors compared to baseline but there were no significant changes in medical outcomes
Weeks et al.	2009	Intervention study	USA	To investigate outcomes of a peer HIV prevention program with PWUD through a project called "The Risk Avoidance Partnership" project	Results show a significant HIV risk reduction among all study participants at 6 months follow-up compared to baseline
A call for increasing the engagement of PWUD in policy making decisions
Canadian HIV/AIDS Legal Network	2005	Report	Canada	To explain why PWUD need to be involved in the response to blood borne diseases and drug use	Recommendations to increase meaningful involvement of PWUD were highlighted
Charlois	2009	Report	Netherlands	To address issues of substance use and trafficking at frontline levels	Recommendations to increase involvement of drug users' participation through expertise and practice sharing
Kerr et al.	2006	Community-based case study	Canada	To document the activities and structure of VANDU using a community-based case methodology	VANDU is highly involved in advocacy, activism, and public education of PWUD and provide support and care for their peers
Osborn & Small	2006	Response article	Canada	To understand the role of PWUD in influencing drug policies in Vancouver, BC	Organizations such as VANDU have enormous impact on municipal drug policy through activism
UNAIDS	2007	Policy brief	-	To highlight challenges, actions, and the importance of the greater involvement of PLWHA	Recommendations to achieving greater involvement of PLWHA through government actions and actions from organizations of PLWHA; challenges include weak management, low skill levels, lack of funding

PWUD: people who use drugs.

IDU: people who inject drugs.

PWLHA: people living with HIV/AIDS.

AOR: adjusted odds ratio.

VANDU: Vancouver Area Network of Drug Users.

TOI: traditional outreach intervention.

PDI: peer driven intervention.