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.
Resumen
Las intervenciones que pretenden cambiar el comportamiento para prevenir el VIH o para aydar a las personas infectadas por el VIH frecuentemente incluyen a los trabajadores no profesionales como promotores de salud, o “pares”. Sin embargo, los datos sobre la eficacia de las intervenciones que utilizan pares apenas están acumulando recientemente. Esta revisión sistemática describe los resultados de una revista de la literatura global, la cual identificó 117 estudios que evalúan la eficacia de las intervenciones basadas en pares relacionadas con el VIH. Aproximadamente la mitad de los estudios fueran llevados a cabo en los países en desarrollo y la mitad en los países desarrollados. Representando diversas poblaciones y tipos de intervenciones, la mayor parte de los estudios demuestra apoyo para el uso de pares, según resultados relacionados con comportamiento sexual riesgoso, las actitudes y la cognición, los conocimientos relacionados con el VIH, y el uso de sustancias. Sin embargo, los resultados medidos por datos biológicos y otros datos objetivos mostraron menos tendencia a indicar una intervención eficaz. En general, los resultados parcialmente apoyan el uso de las intervenciones basadas en pares pero todavía se precisan mas datos demostrando efectos en estudios de diseño riguroso y con resultados que no son limitados por un sesgo potencial de respuesta.
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The authors would like to thank David Huh and Joyce Yang for their help with study selection and coding.
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Simoni, J.M., Nelson, K.M., Franks, J.C. et al. Are Peer Interventions for HIV Efficacious? A Systematic Review. AIDS Behav 15, 1589–1595 (2011). https://doi.org/10.1007/s10461-011-9963-5
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DOI: https://doi.org/10.1007/s10461-011-9963-5