A Peer-Oriented HIV Prevention Outreach Program for Individuals at High Risk for HIV and Other STIs

This study will determine the effectiveness of a peer outreach intervention in preventing HIV infection in adults at high risk for contracting HIV and other sexually transmitted diseases (STDs).

The persistence of HIV and STD epidemics indicates that more effective, sustainable preventive interventions are needed, particularly for low-income, inner-city populations. This study will determine the effectiveness of a theoretically based peer outreach program in preventing HIV and STD transmission among adults in the Baltimore, Maryland area. Participants will be randomly assigned to receive either a network-oriented peer program emphasizing one's social identity and the goals of protecting one's family and community or group cognitive behavioral therapy (CBT). The peer program will also train participants to provide HIV/STD education to their peers. Participants will be assessed at study entry and during several subsequent follow-up visits. At these study visits, participants will complete questionnaires about their sexual health knowledge and sexual behaviors. Participants and members of their peer network will have follow-up visits at Months 6, 12, and 18.

Sex Education, Peer Group, Social Identity Theory, HIV Seronegativity, Intervention, women, Social Networks, Peer Education

Participants received the program over the course of five small group sessions and one individual session based on a harm reduction philosophy. Participants were trained as Peer Mentors and were encouraged to talk to their family, friends, and sex partners about a range of sex risk reduction options.

The comparison condition consisted of one group session. The session focused on HIV and STIs transmission and risk reduction information.

Index participants generated a list of network members during their baseline visits and were asked to recruit eligible network members into the study. These network participants completed study interviews but did not participate in the intervention.

This arm includes those index participants that did not show up for randomization or did not recruit a network member were thus not eligible to be randomized into a study condition.

The peer-oriented intervention program emphasized social identity and the goals of protecting family and community. The peer program also trained participants to provide HIV/STD education to their peers.

Group CBT will focus on teaching ways to modify thoughts and behaviors associated with risky sexual behaviors.

Inclusion Criteria for CBT or Peer Intervention Participants: Female Age 18-55 Did not inject drugs in the past 6 months Self-reported sex with at least 1 male partner in the past 6 months Had at least 1 of the following sexual risk factors: More than 2 sex partners in the past 6 months STI diagnosis in the past 6 months Had a high risk sex partner in the past 90 days (i.e. a sex partner that injected drugs, smoked crack, was HIV+, or MSM) Inclusion Criteria for Peer Network Participants: 18 years old or older One of the following: Injected drugs Sex partner of index Social network member that the index felt comfortable talking to about HIV/STIs Exclusion Criteria for All Participants: Currently enrolled in another HIV prevention intervention