Amirkhanian Yuri A, Kelly Jeffrey A, Kabakchieva Elena, McAuliffe Timothy L, Vassileva Sylvia
Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, 2017 N Summit Avenue, Milwaukee 53202, USA.
AIDS Educ Prev. 2003 Jun;15(3):205-20. doi: 10.1521/aeap.15.4.205.23832.
HIV prevention, by intervening within social networks, is potentially important but highly understudied. Approaches that systematically identify, train, and enlist known social influence leaders to advise members of their own networks in risk reduction constitute ways to reach hidden population segments, persons who are distrustful of authorities but trust their peers, and those who cannot be reached through traditional professionally delivered counseling. This article illustrates and provides evaluation data on a program that recruited 14 intact social networks of young men who have sex with men (YMSM) in St. Petersburg, Russia, and Sofia, Bulgaria. Sociometric measures were used to identify the social leader of each network, and baseline risk assessment measures were administered to all members of each social network. The sociometrically determined leaders then attended a six-session group program that provided training and guidance in how to carry out theory-based and tailored HIV prevention conversations with members of their own social networks. Four months after leaders completed the program, all network members were readministered risk assessment measures. Pre- to postintervention data revealed that the program produced: (1) increases in the level and comfort with which network members talked about AIDS prevention topics in their daily conversations; (2) increased network-level AIDS risk reduction knowledge and improved risk reduction norm perceptions, attitudes, behavioral intentions, and self-efficacy; and (3) increased condom use levels among network members. Although not a controlled, randomized trial, these program evaluation findings strongly support the feasibility of social network-level HIV prevention approaches.
通过在社交网络中进行干预来预防艾滋病具有潜在的重要性，但目前研究甚少。系统地识别、培训并招募有影响力的社交领袖，让他们向自己社交网络中的成员提供降低风险的建议，这种方法能够接触到隐藏的人群，包括那些不信任当局但信任同伴的人，以及那些无法通过传统的专业咨询服务接触到的人。本文阐述了一个项目，并提供了相关评估数据。该项目在俄罗斯圣彼得堡和保加利亚索非亚招募了14个完整的男男性行为青年社交网络。通过社会计量学方法确定每个网络的社交领袖，并对每个社交网络的所有成员进行基线风险评估。这些通过社会计量学确定的领袖随后参加了一个为期六节的小组项目，该项目提供了如何与自己社交网络中的成员进行基于理论且量身定制的艾滋病预防对话的培训和指导。在领袖们完成项目四个月后，对所有网络成员再次进行风险评估。干预前后的数据显示，该项目产生了以下效果：（1）网络成员在日常对话中谈论艾滋病预防话题的频率和舒适度有所提高；（2）网络层面的艾滋病风险降低知识增加，对风险降低规范的认知、态度、行为意图和自我效能得到改善；（3）网络成员中避孕套的使用水平有所提高。尽管这不是一项对照随机试验，但这些项目评估结果有力地支持了社交网络层面艾滋病预防方法的可行性。
