Adolescents at high HIV risk say peers should teach prevention

African-American adolescents have some of the highest rates of HIV infection in the United States, and efforts to educate them about preventing the disease must include the help of their adolescent peers, new research suggests.

Despite comprising only 15 percent of the population, young African-Americans make up 61 percent of the new HIV cases among people under age 25. In the region of North Carolina where the new study took place, 85 percent of HIV/AIDS cases occur among African-Americans.

"Although the youth in our study were not aware of the specific statistics as they related to the prevalence of HIV in their communities and among their peers, they did know that it was very prevalent and that everyone from babies to the elderly - regardless of HIV status - could be affected by it in one way or another," said lead author Dionne Smith Coker-Appiah, an assistant professor at Georgetown University School of Medicine.

The study appears in the latest issue of the journal Progress in Community Health Partnerships: Research, Education and Action. Coker-Appiah and colleagues asked young people about what types of community-based HIV intervention programs worked best in reaching their peer group.

The researchers held four focus groups with 38 young African-Americans (between ages 16 and 24) who live in two rural North Carolina counties. One finding of the focus groups was that young people should undergo training to become peer educators, because they are more likely to get the attention and investment of other youth - more than adult educators would.

Lloyd Kolbe, associate dean for global and community health at Indiana University, agreed.

"Whether we would like them to or not, peers are sex educators," he said. "They always have been, no matter their age, their objective or their wisdom."

"Peer education works at every age, most beneficently among the young and tender, when we learn what love and sex, responsibility and caring are all about," Kolbe added. "We of older years could help, should help, more. But, we're convinced other subjects are far more important to learn."

Kolbe's point was echoed in the participants' responses that also said sexuality and HIV prevention should be taught at a much younger age (before puberty) rather than to older adolescents in an effort to "catch them while they're young." The focus groups also felt that people already living with HIV/AIDS could deliver the most effective messages for prevention.

"We were pleased to find a consistent theme across the participants that suggest that people living with HIV/AIDS would be powerful collaborators," Coker-Appiah said. "The participants believed in the efficacy of recruiting such collaborators because they were aware of the powerful impact that their personal stories could have on their sexual decision.