Peer Referral for HIV Case-Finding Among Men Who Have Sex With Men
December 22, 2006
Researchers in the current study sought to evaluate the effectiveness and cost-effectiveness of a health department-based peer referral program for identifying previously undiagnosed HIV cases among men who have sex with men (MSM).
From 2002 to 2005, 283 MSM peer recruiters were enrolled in a public health program in King County, Wash. Participants were recruited from an STD clinic, an HIV clinic, via media advertisements and through collaboration with community-based organizations (CBO). After undergoing a brief training, recruiters were paid $20 for each peer they referred for HIV, STD and viral hepatitis testing. Those who sought testing received $20. The main outcome measure was the number of new HIV cases identified and cost per case of HIV identified.
A total of 498 peers were referred for testing for HIV, STD and viral hepatitis. Among the 438 not previously diagnosed, 22 (5 percent) were HIV-positive, of whom 18 received their positive results. Researchers found other infections were variably present among those tested, including: gonorrhea [23/307 (8 percent)], chlamydia [6/285 (2 percent)], syphilis [1/445 (0.2 percent)], hepatitis C [61/198 (31 percent)], and surface antigen positive hepatitis B [8/314 (3 percent)]. Not including the costs of testing for viral hepatitis and STDs other than HIV, the cost per new HIV cases identified was $4,929. For the same period, the cost per new case of HIV identified via bathhouse-based HIV testing and through the county's largest CBO-based HIV testing program were $8,250 and $11,481, respectively.
"Peer referral is an effective means of identifying new cases of HIV among MSM," the authors concluded.
AIDS Vol. 20; No. 15: P. 1961-1968
10.03.2006; Matthew R. Golden; Thomas L. Gift; Devon D. Brewer; Mark Fleming; Matthew Hogben; Janet S. St. Lawrence; Hanne Thiede; H. Hunter Handsfield