Use of a Peer Health Educator and Job Readiness Training Program As a Component of a Human Immunodeficiency Virus and Sexually Transmitted Infection Prevention Intervention Program for Self-Identified High-Risk Clients in an Urban North Carolina County

Background:  Local statistics have consistently shown high rates of human immunodeficiency virus (HIV) and sexually transmitted infections (STI) within currently and previously incarcerated populations. We   partnered with a local agency to provide testing, risk-reduction techniques, counseling, and peer health educator training to formerly incarcerated individuals with a goal to disseminate STI prevention messages and promote HIV/STI testing. 

Methods:  A total of 42 self-identified ex-offenders participated in eleven 12-week training programs from February 2012 to December 2015. Each group participated in weekly peer educator and job readiness training along with conducting STI/HIV peer education and community based testing. Pre- and post-session evaluations were completed to assess participants’ knowledge of HIV/STIs. 

Results:  35 program participants (83%) increased HIV/STI knowledge over the course of the program. 5,134 individuals were reached with HIV/STI education. High positivity rates of infection for HIV (1% of 1,420 tests), Syphilis (4% of 1,430 tests), Gonorrhea (2% of 1,244 tests), Chlamydia (3% of 1,244 tests), and Hepatitis C (12% of 187 tests) were found through this outreach program.  Risk behaviors of those tested include men having sex with other men (5%),  injection drug use or sex with someone who injects drugs (5%), sex while under the influence of any drug (6%), history of STI within last six months (3%), two or more partners within the last six months (34%), and sometimes or never used a condom in the last six months (30%).

Conclusions:  The high-risk individuals trained as peer educators through this program were able to focus testing and prevention efforts in communities with similar risk for STIs and HIV. Successfully training self-identified high-risk clients to be peer health educators allows us to reach individuals at high risk for HIV or STI infection, identify new infection, and connect individuals to treatment options.