The Co-Evolution of Network Structure and PrEP Adoption among a Large Cohort of PrEP Peer Leaders: Implications for Intervention Evaluation and Community Capacity-Building

Abstract

Background: Peer leader interventions are effective strategies for promoting prevention behaviors in communities at risk for HIV, yet little is known about their effects on the social and behavioral dynamics of peer leaders themselves. Methods: Using data from PrEP Chicago, an RCT PrEP for prevention intervention for young Black MSM (YBMSM), we apply stochastic actor-based models to longitudinally model the impact of study participation on the online friendship and PrEP adoption dynamics among a network of peer leaders (n = 174) and a network of control group counterparts (n = 166). Results: Peer leaders assigned to the same leadership training workshop were more likely to form new Facebook friendships with one another, whereas control participants assigned to the same attention control workshop were no more or less likely to form new friendships. Further, peer leaders with greater PrEP intentions and those living with HIV were more active in forming new friendships with other peer leaders, effects not found in the control network. PrEP adoption was not influenced by network dynamics in either group. Conclusions: The implications of these findings are discussed through the lens of community-capacity building and the role that peer leader interventions and the networks they engage can impact public health.

Strategies to Close the PrEP Uptake Gap Among Transgender People and Men Who Have Sex with Men in Tshwane, South Africa: Perspectives from the Community

“…In addition, they have practice with taking a prescription daily and conversations of disclosure. Several studies among MSM demonstrated the desire for peer-matching based on identity considerations and lived experience to access PrEP, and that peer leaders with greater PrEP intentions and those living with HIV were more active in forming new friendships [ 36 , 37 ]. Thus, there is benefit to involving interested HIV-positive individuals in PrEP educational efforts and developing curricula specific to initiating conversation about PrEP with a sexual partner.…”