Peer Education for HIV Prevention Among High-risk Groups: a Systematic Review and Meta-analysis

Overview

Journal BMC Infect Dis

Publisher Biomed Central

Specialty Infectious Diseases

Date 2020 May 14

PMID 32398032

Citations 36

Authors

Jiayu He

Ying Wang

Zhicheng Du

Jing Liao

Na He

Yuantao Hao

Affiliations

Soon will be listed here.

Abstract

Background: Peer education has become a strategy for health promotion among high-risk groups for HIV infection worldwide. However, the extent to which peer education could have an impact on HIV prevention or the long-term effect of this impact is still unknown. This study thus quantifies the impact of peer education over time among high-risk HIV groups globally.

Method: Following the PRISMA guidelines, a systematic review and meta-analysis was used to assess the effects and duration of peer education. A thorough literature search of PubMed, Web of Science, Embase and Cochrane Library was performed, and studies about peer education on high-risk HIV groups were reviewed. Pooled effects were calculated and the sources of heterogeneity were explored using meta-regression and subgroup analysis.

Results: A total of 60 articles with 96,484 subjects were identified, and peer education was associated with 36% decreased rates of HIV infection among overall high risk groups (OR: 0.64; 95%CI: 0.47-0.87). Peer education can promote HIV testing (OR = 3.19; 95%CI:2.13,4.79) and condom use (OR = 2.66, 95% CI: 2.11-3.36) while reduce equipment sharing (OR = 0.50; 95%CI:0.33,0.75) and unprotected sex (OR = 0.82; 95%CI: 0.72-0.94). Time trend analysis revealed that peer education had a consistent effect on behavior change for over 24 months and the different follow-up times were a source of heterogeneity.

Conclusion: Our study shows that peer education is an effective tool with long-term impact for behavior change among high-risk HIV groups worldwide. Low and middle-income countries are encouraged to conduct large-scale peer education.

Citing Articles

Women's experiences and acceptability of self-administered, home delivered, intravaginal 5-Fluorouracil cream for cervical precancer treatment in Kenya.

Adewumi K, Kachoria A, Adoyo E, Rop M, Owaya A, Tang J Front Reprod Health. 2025; 7:1487264.

PMID: 39980670 PMC: 11839715. DOI: 10.3389/frph.2025.1487264.

An Open Letter on Advancing HIV prevention: Augmenting an ecosystem-based approach to understand prevention decision-making.

Gantayat N, Baer J, Gangaramany A, Pierce-Messick R Gates Open Res. 2025; 8:73.

PMID: 39898111 PMC: 11785587. DOI: 10.12688/gatesopenres.16067.2.

Barriers facilitators and needs of female sex workers in Arak to access sexual health services a qualitative study.

Navidi I, Shakibazadeh E, Raisi F, Akbarpour S Sci Rep. 2025; 15(1):2424.

PMID: 39827244 PMC: 11742978. DOI: 10.1038/s41598-024-84206-5.

Evaluation of care for people with HIV in Primary Health Care: construct validation.

Pinho C, Cabral J, Lima M, Silva M, de Oliveira R, Aquino J Rev Bras Enferm. 2025; 77(6):e20230190.

PMID: 39813521 PMC: 11731853. DOI: 10.1590/0034-7167-2023-0190.

Sources of HIV information and women's HIV knowledge in Southwest Sumba Indonesia: a cross-sectional study with mediation analysis.

Kurniadi A, Levy J, Johnson T BMC Public Health. 2025; 25(1):33.

PMID: 39754153 PMC: 11699777. DOI: 10.1186/s12889-024-21232-y.

References

Garfein R, Golub E, Greenberg A, Hagan H, Hanson D, Hudson S . A peer-education intervention to reduce injection risk behaviors for HIV and hepatitis C virus infection in young injection drug users. AIDS. 2007; 21(14):1923-32. DOI: 10.1097/QAD.0b013e32823f9066. View

Holtz T, Pattanasin S, Chonwattana W, Tongtoyai J, Chaikummao S, Varangrat A . Longitudinal analysis of key HIV-risk behavior patterns and predictors in men who have sex with men, Bangkok, Thailand. Arch Sex Behav. 2015; 44(2):341-8. DOI: 10.1007/s10508-014-0427-7. View

Shaikh S, Mburu G, Arumugam V, Mattipalli N, Aher A, Mehta S . Empowering communities and strengthening systems to improve transgender health: outcomes from the Pehchan programme in India. J Int AIDS Soc. 2016; 19(3 Suppl 2):20809. PMC: 4949313. DOI: 10.7448/IAS.19.3.20809. View

Higgins J, Thompson S, Deeks J, Altman D . Measuring inconsistency in meta-analyses. BMJ. 2003; 327(7414):557-60. PMC: 192859. DOI: 10.1136/bmj.327.7414.557. View

Bagnall A, South J, Hulme C, Woodall J, Vinall-Collier K, Raine G . A systematic review of the effectiveness and cost-effectiveness of peer education and peer support in prisons. BMC Public Health. 2015; 15:290. PMC: 4404270. DOI: 10.1186/s12889-015-1584-x. View

Ye S, Yin L, Amico R, Simoni J, Vermund S, Ruan Y . Efficacy of peer-led interventions to reduce unprotected anal intercourse among men who have sex with men: a meta-analysis. PLoS One. 2014; 9(3):e90788. PMC: 3948720. DOI: 10.1371/journal.pone.0090788. View

Latkin C, Donnell D, Liu T, Davey-Rothwell M, Celentano D, Metzger D . The dynamic relationship between social norms and behaviors: the results of an HIV prevention network intervention for injection drug users. Addiction. 2013; 108(5):934-43. PMC: 3628934. DOI: 10.1111/add.12095. View

Konate I, Traore L, Ouedraogo A, Sanon A, Diallo R, Ouedraogo J . Linking HIV prevention and care for community interventions among high-risk women in Burkina Faso--the ARNS 1222 "Yerelon" cohort. J Acquir Immune Defic Syndr. 2011; 57 Suppl 1:S50-4. DOI: 10.1097/QAI.0b013e3182207a3f. View

Latkin C, Donnell D, Metzger D, Sherman S, Aramrattna A, Davis-Vogel A . The efficacy of a network intervention to reduce HIV risk behaviors among drug users and risk partners in Chiang Mai, Thailand and Philadelphia, USA. Soc Sci Med. 2008; 68(4):740-8. PMC: 2724962. DOI: 10.1016/j.socscimed.2008.11.019. View

10.

Jain B, Krishnan S, Ramesh S, Sabarwal S, Garg V, Dhingra N . Effect of peer-led outreach activities on injecting risk behavior among male drug users in Haryana, India. Harm Reduct J. 2014; 11:3. PMC: 3922610. DOI: 10.1186/1477-7517-11-3. View

11.

Adebajo S, Eluwa G, Njab J, Oginni A, Ukwuije F, Ahonsi B . Evaluating the effect of HIV prevention strategies on uptake of HIV counselling and testing among male most-at-risk-populations in Nigeria; a cross-sectional analysis. Sex Transm Infect. 2015; 91(8):555-60. DOI: 10.1136/sextrans-2014-051659. View

12.

Medley A, Kennedy C, OReilly K, Sweat M . Effectiveness of peer education interventions for HIV prevention in developing countries: a systematic review and meta-analysis. AIDS Educ Prev. 2009; 21(3):181-206. PMC: 3927325. DOI: 10.1521/aeap.2009.21.3.181. View

13.

Pawa D, Firestone R, Ratchasi S, Dowling O, Jittakoat Y, Duke A . Reducing HIV risk among transgender women in Thailand: a quasi-experimental evaluation of the sisters program. PLoS One. 2013; 8(10):e77113. PMC: 3812213. DOI: 10.1371/journal.pone.0077113. View

14.

Yan H, Zhang R, Wei C, Li J, Xu J, Yang H . A peer-led, community-based rapid HIV testing intervention among untested men who have sex with men in China: an operational model for expansion of HIV testing and linkage to care. Sex Transm Infect. 2014; 90(5):388-93. DOI: 10.1136/sextrans-2013-051397. View

15.

Basu I, Jana S, Rotheram-Borus M, Swendeman D, Lee S, Newman P . HIV prevention among sex workers in India. J Acquir Immune Defic Syndr. 2004; 36(3):845-52. PMC: 2826108. DOI: 10.1097/00126334-200407010-00012. View

16.

Purcell D, Latka M, Metsch L, Latkin C, Gomez C, Mizuno Y . Results from a randomized controlled trial of a peer-mentoring intervention to reduce HIV transmission and increase access to care and adherence to HIV medications among HIV-seropositive injection drug users. J Acquir Immune Defic Syndr. 2008; 46 Suppl 2:S35-47. DOI: 10.1097/QAI.0b013e31815767c4. View

17.

Wong T, Pharr J, Bungum T, Coughenour C, Lough N . Effects of Peer Sexual Health Education on College Campuses: A Systematic Review. Health Promot Pract. 2018; 20(5):652-666. DOI: 10.1177/1524839918794632. View

18.

Mainkar M, Pardeshi D, Dale J, Deshpande S, Khazi S, Gautam A . Targeted interventions of the Avahan program and their association with intermediate outcomes among female sex workers in Maharashtra, India. BMC Public Health. 2012; 11 Suppl 6:S2. PMC: 3287555. DOI: 10.1186/1471-2458-11-S6-S2. View

19.

Mi G, Wu Z, Wang X, Shi C, Yu F, Li T . Effects of a Quasi-Randomized Web-Based Intervention on Risk Behaviors and Treatment Seeking Among HIV-Positive Men Who Have Sex With Men in Chengdu, China. Curr HIV Res. 2015; 13(6):490-6. PMC: 6556536. DOI: 10.2174/1570162x13666150624104522. View

20.

Mihailovic A, Tobin K, Latkin C . The influence of a peer-based HIV prevention intervention on conversation about HIV prevention among people who inject drugs in Baltimore, Maryland. AIDS Behav. 2015; 19(10):1792-800. PMC: 4567430. DOI: 10.1007/s10461-015-1048-4. View