Peer education for HIV prevention among high-risk groups: a systematic review and meta-analysis

Jiayu He, Ying Wang, Zhicheng Du, Jing Liao, Na He, Yuantao Hao
2020 · doi:10.21203/rs.2.13653/v3
preprint OA: closed CC-BY-4.0
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Abstract

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 96484 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.

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License: CC-BY-4.0