Department of Medicine, University of Chicago, 5841 S. Maryland Ave., MC 5065, Chicago, IL 60637, USA.
Soc Sci Med. 2012 Oct;75(7):1192-201. doi: 10.1016/j.socscimed.2012.05.022. Epub 2012 Jun 15.
Despite limited HIV prevention potency, peer-based programs have become one of the most often used HIV prevention approaches internationally. These programs demonstrate a need for greater specificity in peer change agent (PCA) recruitment and social network evaluation. In the present three-phase study based in India (2009-2010), we first explored the nature of friendship among truck-drivers, a group of men at high risk for HIV infection, in order to develop a thorough understanding of the social forces that contribute to and maintain their personal networks. This was accomplished in the first two study phases through a combination of focus group discussions (n = 5 groups), in-depth qualitative interviews (n = 20), and personal network analyses (n = 25) of truck-drivers to define friendship and deepen our understanding of friendship across geographic spaces. Measures collected in phases I and II included friend typologies, discussion topics, social network influences, advice-giving, and risk reduction. Outcomes were assessed through an iterative process of qualitative textual analysis and social network analysis. The networks of truck-drivers were found to comprise three typologies: close friends, parking lot friends, and other friends. From these data, we developed an algorithmic approach to the identification of a candidate PCA within a high-risk man's personal network. In phase III we piloted field-use of this approach to identify and recruit PCAs, and further evaluated their potential for intervention through preliminary analysis of the PCA's own personal networks. An instrument was developed to translate what social network theory and analysis has taught us about egocentric network dynamics into a real-world methodology for identifying intervention-appropriate peers within an individual's personal network. Our approach can be tailored to the specifications of any high-risk population, and may serve to enhance current peer-based HIV interventions.
尽管艾滋病毒预防效果有限,但基于同伴的方案已成为国际上最常采用的艾滋病毒预防方法之一。这些方案表明,需要更加具体地招募同伴改变代理人(PCA)并评估社交网络。在本项基于印度的三阶段研究中(2009-2010 年),我们首先探讨了卡车司机群体中友谊的性质,卡车司机是感染艾滋病毒风险较高的群体之一,以便深入了解促成和维持其个人网络的社会力量。这在前两个研究阶段通过以下方式实现:对卡车司机进行焦点小组讨论(n=5 组)、深入的定性访谈(n=20)和个人网络分析(n=25),以定义友谊并加深我们对跨地理空间的友谊的理解。第一和第二阶段收集的措施包括朋友类型、讨论主题、社交网络影响、提供建议和减少风险。通过定性文本分析和社交网络分析的迭代过程评估结果。发现卡车司机的网络包括三种类型:亲密朋友、停车场朋友和其他朋友。从这些数据中,我们开发了一种算法方法,用于确定高危男子个人网络中的 PCA。在第三阶段,我们试用了这种方法来识别和招募 PCA,并通过对 PCA 自己的个人网络进行初步分析,进一步评估他们进行干预的潜力。开发了一种工具,将社交网络理论和分析教会我们的关于自我中心网络动态的知识转化为在个人网络中识别适合干预的同伴的实际方法。我们的方法可以根据任何高危人群的具体情况进行调整,并可能有助于增强当前基于同伴的艾滋病毒干预措施。