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Community AIDS/HIV risk reduction: The effects of endorsements by popular people in three cities

Author

Listed:
  • Kelly, J.A.
  • St. Lawrence, J.S.
  • Stevenson, L.Y.
  • Hauth, A.C.
  • Kalichman, S.C.
  • Diaz, Y.E.
  • Brasfield, T.L.
  • Koob, J.J.
  • Morgan, M.G.

Abstract

Objectives. It is critical to extend community-level acquired immunodeficiency syndrome (AIDS) prevention efforts beyond education alone and to develop models that better encourage behavioral changes. Gay men in small cities are vulnerable to human immunodeficiency virus (HIV) infection due to continued high rates of risk behavior. This research introduced an intervention that trained popular people to serve as behavioral change endorsers to peers sequentially across three different cities. Methods. Populationwide surveys were conducted of all men patronizing gay clubs in each city to establish risk behavior base rates. After a small cadre of popular 'trendsetters' were identified, they received training in approaches for peer education and then contracted to communicate risk reduction recommendations and endorsements to friends. Surveys were repeated at regular intervals in all cities, with the same intervention introduced in lagged fashion across each community. Results. Intervention consistently produced systematic reductions in the population's high-risk behavior (unprotected anal intercourse) of 15% to 29% from baseline levels, with the same pattern of effects sequentially replicated in all three cities. Conclusions. This constitutes the first controlled, multiple-city test of an HIV prevention model targeting communities. The results support the utility of norm-changing approaches to reduce HIV risk behavior.

Suggested Citation

  • Kelly, J.A. & St. Lawrence, J.S. & Stevenson, L.Y. & Hauth, A.C. & Kalichman, S.C. & Diaz, Y.E. & Brasfield, T.L. & Koob, J.J. & Morgan, M.G., 1992. "Community AIDS/HIV risk reduction: The effects of endorsements by popular people in three cities," American Journal of Public Health, American Public Health Association, vol. 82(11), pages 1483-1489.
    • Handle: RePEc:aph:ajpbhl:1992:82:11:1483-1489_5
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    Cited by:

    1. Rong, Rong & Houser, Daniel, 2015. "Growing stars: A laboratory analysis of network formation," Journal of Economic Behavior & Organization, Elsevier, vol. 117(C), pages 380-394.
    2. Lindsay E. Young & John A. Schneider, 2021. "The Co-Evolution of Network Structure and PrEP Adoption among a Large Cohort of PrEP Peer Leaders: Implications for Intervention Evaluation and Community Capacity-Building," IJERPH, MDPI, vol. 18(11), pages 1-19, June.
    3. Glenn Laverack, 2018. "The Challenge of Promoting the Health of Refugees and Migrants in Europe: A Review of the Literature and Urgent Policy Options," Challenges, MDPI, vol. 9(2), pages 1-12, August.
    4. Alexander Cardazzi & Joshua C. Martin & Zachary Rodriguez, 2023. "Information shocks and celebrity exposure: The effect of “Magic” Johnson on AIDS diagnoses and mortality in the U.S," Health Economics, John Wiley & Sons, Ltd., vol. 32(9), pages 2047-2079, September.
    5. Alexander Cardazzi & Joshua Martin & Zachary Rodriguez, 2021. "Information Avoidance and Celebrity Exposure: The Effect of "Magic" Johnson on AIDS Diagnoses and Mortality in the U.S," Working Papers 21-04, Department of Economics, West Virginia University.
    6. Grant Miller & A. Mushfiq Mobarak, 2013. "Gender Differences in Preferences, Intra-Household Externalities, and Low Demand for Improved Cookstoves," NBER Working Papers 18964, National Bureau of Economic Research, Inc.
    7. Crittenden, Kathleen S. & Kaponda, Chrissie P.N. & Jere, Diana L. & McCreary, Linda L. & Norr, Kathleen F., 2015. "Participation and diffusion effects of a peer-intervention for HIV prevention among adults in rural Malawi," Social Science & Medicine, Elsevier, vol. 133(C), pages 136-144.
    8. Fetta, Angelico & Harper, Paul & Knight, Vincent & Williams, Janet, 2018. "Predicting adolescent social networks to stop smoking in secondary schools," European Journal of Operational Research, Elsevier, vol. 265(1), pages 263-276.

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