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Individual and Social Network Structure Characteristics Associated with Peer Change Agent Engagement and Impact in a PrEP Intervention

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Abstract

Interventions that utilize the influence of peer change agents (PCAs) have been shown to be effective strategies for engaging key populations in HIV prevention. To date, little is known about the characteristics of PCAs associated with their effectiveness. Drawing on data from a peer leader PrEP intervention for young Black men who have sex with men (YBMSM) (N = 423), we evaluated the effects of experiential (i.e., living with HIV, PrEP awareness, PrEP use), psychographic (i.e., self-perceived leadership, innovativeness), and network (i.e., degree centrality, eigenvector centrality, and brokerage) characteristics on three effectiveness outcomes: (1) recruiting peers into the study; (2) completing “booster” sessions; and (3) linking peers to PrEP care. For each outcome, multivariable regressions were performed. On average, PCAs recruited 0.89 peers, completed 1.99 boosters, and had 1.33 network peers linked to PrEP care. Experiential factors: Prior PrEP awareness was positively associated with booster completion. Network factors: Being a network broker (i.e., connecting otherwise disconnected communities) was positively associated with peer recruitment but negatively associated with linking peers to PrEP, and degree centrality (i.e., the number of network connections someone has) and eigenvector centrality (i.e., being connected to well-connected network associates) were positively associated with linking peers to PrEP. Psychographic characteristics were not associated with any outcome. These findings can be used to inform PCA selection and to identify subpopulations who require additional support to excel as PCAs.

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Acknowledgements

This study was conducted under the auspices of the PrEP Chicago study team. We would like to thank intervention staff and our partners at the National Opinion Research Center (NORC) at the University of Chicago for their invaluable support. We also would like to thank study participants for their time and commitment to the study.

Funding

This work was supported by NIH Grants R01AI20700 and K99HD094648.

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Authors and Affiliations

  1. Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA

    Tim Walsh

  2. Department of Medicine, University of Chicago, Chicago, IL, USA

    John A. Schneider & Babak Mahdavi Ardestani

  3. Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, USA

    John A. Schneider & Babak Mahdavi Ardestani

  4. Department of Public Health Sciences, University of Chicago, Chicago, IL, USA

    John A. Schneider

  5. Annenberg School for Communication and Journalism, University of Southern California, Los Angeles, CA, USA

    Lindsay E. Young

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  1. Tim Walsh
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  4. Lindsay E. Young
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Correspondence to Lindsay E. Young.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Walsh, T., Schneider, J.A., Ardestani, B.M. et al. Individual and Social Network Structure Characteristics Associated with Peer Change Agent Engagement and Impact in a PrEP Intervention. AIDS Behav 24, 3385–3394 (2020). https://doi.org/10.1007/s10461-020-02911-4

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