In El Salvador, crack users
are at high risk for HIV but they are not targeted by efforts to promote early
HIV diagnosis.
We evaluated the promise of peer-referral chains with incentives
to increase HIV testing and identify undiagnosed HIV infections among networks
of crack users in San Salvador. For 14 months, we offered HIV testing in
communities with a high prevalence of crack use. For the following
14 months, we promoted chains in which crack users from these communities
referred their peers to HIV testing and received a small monetary incentive. We
recorded the monthly numbers of HIV testers, and their crack use, sexual risk
behaviors and test results.
After launching the referral chains, the monthly
numbers of HIV testers increased significantly (Z = 6.90,
p < .001) and decayed more slowly (Z = 5.93, p < .001),
and the total number of crack-using testers increased nearly fourfold. Testers
in the peer-referral period reported fewer HIV risk behaviors, but a similar
percentage (~5 %) tested HIV positive in both periods. More women than men
received an HIV-positive diagnosis throughout the study (χ2(1, N = 799) = 4.23,
p = .040).
Peer-referral chains with incentives can potentially
increase HIV testing among networks of crack users while retaining a focus on
high-risk individuals.
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By: Glasman LR1, Dickson-Gomez J2, Lechuga J3, Tarima S4, Bodnar G5, de Mendoza LR6.
- 1Center for AIDS Intervention Research, Medical College of Wisconsin, 2071 N Summit Ave., Milwaukee, WI, USA. lglasman@mcw.edu.
- 2Center for AIDS Intervention Research, Medical College of Wisconsin, 2071 N Summit Ave., Milwaukee, WI, USA.
- 3Department of Psychology, University of Texas, El Paso, TX, USA.
- 4Division of Biostatistics, Institute for Health and Society, Medical College of Wisconsin, Milwaukee, WI, USA.
- 5Departamento de Investigación, Fundación Antidrogas de El Salvador (FUNDASALVA), Santa Tecla, El Salvador.
- 6Department of Psychology, Universidad Centroamericana José Simeón Cañas, San Salvador, El Salvador.
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