Are Peer Interventions for HIV Efficacious? A Systematic Review

Abstract

Behavioral interventions to prevent HIV or assist HIV-positive persons often incorporate peers, yet empirical support for their efficacy is only recently accumulating. We describe the results of a review of the global literature, identifying 117 studies evaluating the efficacy of peer-based interventions in the area of HIV/AIDS. About half were conducted in the developing world and half in Western nations. Across a range of populations and intervention modalities, the majority of studies provided some support for peer interventions according to outcome indicators in the domains of sexual risk behavior, attitudes and cognitions, HIV knowledge, and substance use. However, outcomes assessed using biomarkers and other non-self-report variables were less likely to indicate intervention efficacy. Overall, findings suggest that we can have some confidence in peer interventions, yet more data are needed demonstrating an effect in the most rigorous study designs and with outcomes that are not potentially affected by respondent bias.

“Trust Me, It’s Different”: Experiences of Peer Case Management of Women Living with HIV in Ontario, Canada

“…Peer interventions in HIV may alleviate demands on healthcare systems while offering social and practical supports vis-à-vis assistance with daily living (Heckman, Somlai, Sikkema, Kelly, & Franzoi, 1997). These interventions have been promoted by international bodies (Simoni, Nelson, Franks, Yard, & Lehavot, 2011; U.S. President's Emergency Plan for AIDS Relief, 2009), however the potential uniqueness of a women-centred approach in HIV-specifi c peer interventions is missing from the literature (Boyd et al, 2005).…”

“…Although peer support research has increased in many areas (Hilfi nger-Messias, Moneyham, Vyavaharkar, Murdaugh, & Phillips, 2009;Simoni, Nelson, Franks, Yard, & Lehavot, 2011), more in-depth, theoretical, and contexualized knowledge of peer support is needed , particularly for WLWH who represent a range of cultures and social locations.…”

“…Research has recently responded with more rigorous evaluations of peer interventions (Maticka-Tyndale & Barnett, 2010;Simoni, Nelson, Franks, Yard, & Lehavot, 2011;Webel, Okonsky, Trompeta, & Holzemer, 2010). However, diversity in methodology, outcomes, and reporting have limited generalizability from published studies (Simoni, Nelson, Franks, Yard, & Lehavot, 2011) making consensus regarding effi cacy a formidable challenge.…”

“…However, diversity in methodology, outcomes, and reporting have limited generalizability from published studies (Simoni, Nelson, Franks, Yard, & Lehavot, 2011) making consensus regarding effi cacy a formidable challenge. Researchers posit that we can have some confi dence in peer interventions but require more rigorous research to demonstrate an effect (Simoni, Nelson, Franks, Yard, & Lehavot, 2011). Limited research, however, has examined why peer support may be a unique form of social support for WLWH who represent diverse social circumstances.…”

Impact of a customized peer-facilitators training program related to sexual health intervention

“…13 Peer education is one of the most widely used strategies throughout the world to address the HIV/AIDS pandemic. 14,15 It typically involves training and supporting members of a given group to effect change among members of that group, and often used to effect changes in knowledge, attitudes, beliefs and behaviors at the individual level. [16][17][18] It can also create change at the group or societal level by modifying norms and stimulating collective action that contributes to changes in policies and programs.…”