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Meta-Analysis
. 2020 May 12;20(1):338.
doi: 10.1186/s12879-020-05003-9.

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

Jiayu He  1   2   3 , Ying Wang  1 , Zhicheng Du  1 , Jing Liao  1 , Na He  2   3 , Yuantao Hao  4
Affiliations
Meta-Analysis

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

Jiayu He et al. BMC Infect Dis. .

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.

Keywords: High risk HIV groups; Meta-analysis; Peer education.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow chart of literature search and selection of studies
Fig. 2
Fig. 2
The forest plot of the HIV testing
Fig. 3
Fig. 3
The forest plot of the equipment sharing
Fig. 4
Fig. 4
The forest plot of the unprotected sex
Fig. 5
Fig. 5
The forest plot of the condom use
Fig. 6
Fig. 6
The forest plot of the HIV prevalence
Fig. 7
Fig. 7
Time trend of peer education effectiveness among HIV high risk groups
See this image and copyright information in PMC

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