Peer education for HIV prevention among high-risk groups: a systematic review and meta-analysis
Abstract Background Peer education has become a strategy for health promotion among HIV groups at high-risk worldwide. However, the quantitative effect and its duration of peer education on preventing HIV is still unknown.Method A systematic review and meta-analysis was adopted to assess the effects and its duration of peer education, following the PRISMA guidelines. A thorough literature search of PubMed, Web of Science, Embase and Cochrane Library was performed, and studies about peer education on HIV high-risk groups were reviewed. Pooled effects were calculated and the heterogeneity source were explored using meta-regression and subgroup analysis.Results A total of 60 articles with 96484 subjects were identified, and peer education was associated with 36% decreased rates of HIV infection among high risk groups overall (OR: 0.64; 95%CI: 0.47-0.87). Peer education can promote HIV testing (OR=3.19; 95%CI:2.13,4.79) better than condom use (OR=2.66, 95% CI: 2.11-3.36) and can reduce equipment sharing (OR=0.50; 95%CI:0.33,0.75) better than unprotected sex (OR=0.82; 95%CI: 0.72-0.94). Time trend analysis showed a persistent effect of peer education and the different follow-up time was a source of heterogeneity.Conclusion Peer education is persistently effective for changing behaviors among high-risk groups worldwide, especially for the behaviors of HIV testing and equipment sharing. Low and middle income countries are encouraged to conduct peer education at a large scale.