Peer education for HIV prevention among high-risk groups: a systematic review and meta-analysis

BMC Infect Dis. 2020 May 12;20(1):338. doi: 10.1186/s12879-020-05003-9.


Background: Peer education has become a strategy for health promotion among high-risk groups for HIV infection worldwide. However, the extent to which peer education could have an impact on HIV prevention or the long-term effect of this impact is still unknown. This study thus quantifies the impact of peer education over time among high-risk HIV groups globally.

Method: Following the PRISMA guidelines, a systematic review and meta-analysis was used to assess the effects and duration of peer education. A thorough literature search of PubMed, Web of Science, Embase and Cochrane Library was performed, and studies about peer education on high-risk HIV groups were reviewed. Pooled effects were calculated and the sources of heterogeneity were explored using meta-regression and subgroup analysis.

Results: A total of 60 articles with 96,484 subjects were identified, and peer education was associated with 36% decreased rates of HIV infection among overall high risk groups (OR: 0.64; 95%CI: 0.47-0.87). Peer education can promote HIV testing (OR = 3.19; 95%CI:2.13,4.79) and condom use (OR = 2.66, 95% CI: 2.11-3.36) while reduce equipment sharing (OR = 0.50; 95%CI:0.33,0.75) and unprotected sex (OR = 0.82; 95%CI: 0.72-0.94). Time trend analysis revealed that peer education had a consistent effect on behavior change for over 24 months and the different follow-up times were a source of heterogeneity.

Conclusion: Our study shows that peer education is an effective tool with long-term impact for behavior change among high-risk HIV groups worldwide. Low and middle-income countries are encouraged to conduct large-scale peer education.

Keywords: High risk HIV groups; Meta-analysis; Peer education.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Acquired Immunodeficiency Syndrome / prevention & control*
  • Acquired Immunodeficiency Syndrome / psychology*
  • Adolescent
  • Adult
  • Condoms
  • Female
  • Health Promotion / methods*
  • Humans
  • Male
  • Mass Screening / trends
  • Peer Group*
  • Risk-Taking
  • Unsafe Sex / prevention & control
  • Young Adult