Rs. Broadhead et al., Harnessing peer networks as an instrument for AIDS prevention: Results from a peer-driven intervention, PUBL HEAL, 113, 1999, pp. 42-57
Citations number
33
Categorie Soggetti
Public Health & Health Care Science","Envirnomentale Medicine & Public Health
Objective. Since 1985, community outreach efforts to combat acquired immuno
deficiency syndrome (AIDS) among injecting drug users (IDUs) in the United
States have overwhelmingly depended on a provider-client model that relies
on staffs of professional outreach workers. We report on a comparison of th
is traditional outreach model with an innovative social network model, term
ed "a peer-driven intervention" (PDI), The latter provides IDUs with guidan
ce and structured incentives that permit them to play a much more active ro
le in the outreach process, thereby harnessing peer pressure on behalf of h
uman immunodeficiency virus (HIV) prevention efforts,
Methods. We compare the performance of a traditional outreach intervention
(TOI) and a PDI that were implemented in medium-sized towns in eastern and
central Connecticut, Comparisons are based on the number and representative
ness of IDUs recruited at each site, the effectiveness of HIV prevention ed
ucation, compliance rates with AIDS risk reduction recommendations, and rel
ative cost, The analyses are based on 552 initial interviews and 190 six-mo
nth follow-up interviews conducted during the first two years of each inter
vention's operation.
Results, Both interventions produced significant reductions in HIV risk beh
aviors, as measured using self-reports. The PDI outperformed the traditiona
l intervention with respect to the number of IDUs recruited, the ethnic and
geographic representativeness of the recruits, and the effectiveness of HI
V prevention education. In addition, the costs of recruiting IDUs into the
intervention and educating them about HIV in the community was only one-thi
rtieth as much in the PDI as in the traditional intervention.
Conclusions. The findings suggest that given guidance and nominal incentive
s, IDUs can play a more extensive role in community outreach efforts than t
he traditional model allows. The findings also suggest that both interventi
ons reduce HIV-associated risk behaviors, but the PDI reaches a larger and
more diverse set of IDUs, and does so at much less expense.