Tapping Youth as Agents for Change: Evaluation of a Peer Leadership HIV/AIDS Intervention

The Journal of Adolescent Health recently published an article evaluating the impact of a community-based HIV/AIDS peer leadership prevention program on adolescents' knowledge of disease prevention and education. The study compared trained peer leaders to adolescents who were not enrolled in peer leadership programs.

Participants

The sample consisted of 235 adolescents, recruited from nine communities in Massachusetts. 164 of the participants were placed in the intervention group and divided into two internal groups. The 67 students who had already participated in a long-term peer leadership program were called repeat leaders. The remaining 97 students were called newly enrolled peer leaders.

Researchers also recruited youth from community and school-based programs that did not use peer education as a means to promote adolescent health but that did offer health-related services such as parenting skills for teenage mothers and some sexuality education. These 71 students belonged to the comparison group.

The Intervention Program

The intervention program was split into two parts. Students first participated in a short fact-based AIDS course. They then collaborated with adult advisors in ongoing group work. Throughout the nine months, intervention group participants learned about HIV transmission, communication and negotiation skills related to sexual risk-taking behaviors, and how to plan HIV-related activities for their peers. At the end of the study, peer leaders had helped implement over 300 outreach activities in their schools and neighborhoods.

Methods

The researchers asked both groups of students to fill out questionnaires that tested their knowledge of HIV/AIDS before and after enrolling in a nine-month intervention program. The before and after surveys measured changes in students' knowledge in five areas: HIV/AIDS facts, planning and presenting skills, self-efficacy, perception of oneself as an agent of change in the community, and ability to identify sexual risk-taking behaviors. The researchers also collected information on specific activities resulting from the intervention program and its perceived benefits.

Researchers analyzed the data in two groups. Group I results compared newly enrolled peer leaders and comparison group participants. Group II examined the difference between repeat peer leaders and newly enrolled peer leaders.

Results

Baseline Characteristics of Group I Taken before the Intervention Program

Sexual Activity

• 30.9% of new peer leaders reported that they were sexually active in the three months prior to the study.
• 45.1% of comparison group participants reported prior sexual activity in the three months prior to the study.

Pressured to Have Intercourse

• 36.8% of the new peer leaders reported having been pressured to have sexual intercourse.
• 47.9% of the comparison group reported having been pressured to have sexual intercourse.

Chance of Getting HIV

• 25.3% of the new peer leaders believed they were at high risk of getting HIV/AIDS.
• 22.9% of the comparison group participants thought they were at high risk of contracting HIV/AIDS.

Agents of Social Change

• 31% of newly enrolled peer leaders saw themselves as agents of social change.
• 28% of comparison group participants felt they could be agents of change.

Reported Benefits of the Intervention Program

Researchers asked the intervention participants to comment on the effectiveness, successes, and perceived benefits of the nine-month program.

• 78.8% of repeat peer leaders and 59% of the new peer leaders thought the intervention was beneficial because it improved students' abilities to effectively facilitate and present sexual health lessons.
• 77.3% of repeat peer leaders and 58% of new peer leaders considered the intervention rewarding because it improved their leadership skills.
• 67% of repeat leaders and 47% of new peer leaders felt the program encouraged accepting different types of people.
• 60% of repeat leaders and 40% of new peer leaders reported higher rates of self-esteem due to the intervention program.

The authors believe this study suggests a peer leadership program can prove an effective strategy to raise adolescents' awareness about HIV/AIDS and sexually transmitted diseases and can also increase their self-esteem as individual agents of social change. The authors note that nine months after the study began, newly enrolled peer leaders knew more about HIV/AIDS prevention and were more confident of their leadership abilities than students who were not enrolled in peer leadership programs.

Finally, the authors believe the study supports the hypothesis that adolescent peer leaders benefit most from training programs when they have sufficient time to implement activities that are meaningful to themselves and their peers. The authors agree that adults should recognize the power of peer educators and peer leaders in preventing adolescents from engaging in risky behavior -- whether sexual or otherwise.

Deborah N. Pearlman, Ph.D., Lois Camberg, Ph.D., Laurie Jo Wallace, Ph.D., Paul Symons, M.B.A., and Lorenz Finison, Ph.D., "Tapping Youth as Agent for Change: Evaluation of a Peer Leadership HIV/AIDS Prevention," Journal of Adolescent Health, vol. 31, no. 1, July 2002, pp. 31-9