Despite efforts to curb the spread of HIV, an estimated 40,000 people in the US acquire HIV infection each year. It is estimated that one quarter of these individuals are unaware of their infection. Partner notification (PN) can be an effective method of reaching persons who are unaware of their HIV exposure, and occurs through two primary methods: self-disclosure (the HIV+ individual informing a risk partner they may have been exposed to HIV) or anonymously (by health department officials). However, little research has been undertaken to enhance HIV PN. In this developmental proposal, a pilot curriculum for training HIV+ peers to communicate about PN will be modified, based on the results of focus groups with HIV positive persons and interviews with service providers from 3 sources: a drug treatment program, an HIV primary care medical clinic, and a community service agency for HIV+ individuals. Using an Information-Motivation Behavioral Skills theoretical model, HIV+ Peers from the three venues will be trained to impart PN information (e.g. anonymity provided though health department notification), address motivation (e.g. altruism, responsibility), and develop skills (e.g. personal disclosure rehearsal/use of anonymous PN service). The PN Peer Education program will be implemented in each venue for a four month period. Feasibility will be assessed through process data, including observations of education activities and interviews with staff. Preliminary efficacy data will be obtained by assessing changes in knowledge, attitudes and use of PN for the trained peers and clients/patients in the three venues via pre and post assessments. In addition, trends in PN reports to the New York City Department of Health and Mental Hygiene will be examined. Results of this developmental study will be used to develop a large-scale randomized clinical trial (RCT) to assess the effectiveness of the Peer Education program on enhancing PN among HIV+ persons. Public Health Relevance Statement To date, Partner Notification has remained an under-utilized but potentially very effective strategy for HIV prevention. Furthermore, since surveillance data indicates that many individuals remain unaware of their HIV positive status for lengthy time periods (thus leading to delayed entry into life-saving treatment and delayed incorporation of risk reduction behaviors), there is a critical need to enhance utilization of PN strategies. The utilization of a peer-education based model for increasing HIV PN, as proposed in this R21 application, holds promise for enhancing PN activities among HIV positive populations. This can lead to earlier entry into treatment for individuals who are HIV+, and can contribute to HIV prevention efforts. ? ? ? ?
