Peer referral for HIV case-finding among men who have sex with men

• Published in: AIDS (London) Vol. 20; no. 15; pp. 1961 - 1968
• Main Authors: GOLDEN, Matthew R, GIFT, Thomas L, BREWER, Devon D, FLEMING, Mark, HOGBEN, Matthew, LAWRENCE, Janet S. St, THIEDE, Hanne, HANDSFIELD, H. Hunter
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 03.10.2006
• Subjects: Adolescent; Adult; AIDS Serodiagnosis; AIDS/HIV; Biological and medical sciences; Epidemiologic Methods; HIV Infections - diagnosis; Homosexuality, Male; Human viral diseases; Humans; Immunodeficiencies; Immunodeficiencies. Immunoglobulinopathies; Immunopathology; Infectious diseases; Male; Medical sciences; Middle Aged; Peer Group; Public Health; Referral and Consultation; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Human; Immunopathology; Homosexuality; Male; AIDS; partner notification; Immune deficiency; peer referral; Infection; HIV; Viral disease; Sex partner; case-finding
• ISSN: 0269-9370; 1473-5571
• DOI: 10.1097/01.aids.0000247118.74208.6a

To evaluate the effectiveness and cost-effectiveness of a health department-based peer referral program for identifying previously undiagnosed cases of HIV among men who have sex with men (MSM). Between 2002 and 2005, 283 MSM peer recruiters were enrolled in a public health program in King County, Washington, USA. Peer recruiters were enrolled from a sexually transmitted disease (STD) clinic, an HIV clinic, via media advertisements and through collaboration with community-based organizations (CBO). The peer recruiters underwent a brief training and were then paid US$ 20 for each peer they referred to be tested for HIV, STD and viral hepatitis. Peers were paid US$ 20 for being tested. The main outcome measure was the number of new cases of HIV identified and cost per case of HIV identified. Recruiters referred 498 peers for HIV, STD and hepatitis testing. Among 438 peers not previously diagnosed with HIV, 22 (5%) were HIV positive, of whom 18 received their HIV test results. Other infections were variably prevalent among tested peers: gonorrhea [23/307 (8%)], chlamydia [6/285 (2%)], syphilis [1/445 (0.2%)], hepatitis C [61/198 (31%)], surface antigen positive hepatitis B [8/314 (3%)]. Excluding the costs of testing for viral hepatitis and STDs other than HIV, the cost per new HIV case identified was US$ 4929. During the same period, the cost per new case of HIV detected through bathhouse-based HIV testing and through the county's largest CBO-based HIV testing program were US$ 8250 and US$ 11 481, respectively. Peer referral is an effective means of identifying new cases of HIV among MSM.