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Abstract
This paper presents a qualitative investigation of peer mentoring among HIV seropositive injection drug users in a randomized controlled trial, the INSPIRE study. Qualitative analyses of 68 in-depth open-ended interviews conducted in 2005 in Baltimore, New York, Miami, and San Francisco revealed that these individuals conceptualized themselves as change agents through the identity of peer mentor at the three related domains of individual, interpersonal, and community-level change. Implications for program development and future research of peer mentoring as a mechanism for HIV prevention are discussed. This study was funded by the Centers for Disease Control and Prevention and Health Resources and Services Administration (HRSA).
THE AUTHORS
Sonja Mackenzie, DrPH, MSc, is adjunct Assistant Professor at the Health Equity Institute at San Francisco State University. Dr. Mackenzie's research addresses the conjoined effects of racism, homophobia, and social class and gender inequalities on HIV/AIDS vulnerability among urban populations of injection drug users, women and girls, and bisexually active Black men. Her work draws on qualitative and ethnographic research methods at the intersections of public health, sociology, and sexuality studies, with a specific focus on participatory methods, including community based participatory research (CBPR). Dr. Mackenzie is currently conducting a qualitative research project of the social context of HIV among bisexually active Black men. Dr. Mackenzie received her Doctorate in Public Health from the University of California, Berkeley, in 2008, and her MS from the Harvard School of Public Health in 2000.
Charles Pearson, MA, is an ethnographer and academic specialist at the Center for AIDS Prevention Studies, University of California-San Francisco. Pearson is also a PhD candidate at the University of California-Davis in Cultural Anthropology.
Victoria Frye, MPH, DrPH, heads the laboratory of Social and Behavioral Sciences at the Lindsley F. Kimball Research Institute of the New York Blood Center and is Assistant Professor of Sociomedical Sciences at the Mailman School of Public Health of Columbia University. Dr. Frye's work combines epidemiological and social science theories and methods to study the distribution, determinants, and health consequences of intimate partner violence and HIV/AIDS. Dr. Frye is a co-principal investigator on two federally funded R01s and the recipient of a mentored career development award. Dr. Frye's work has been published in Journal of the American Medical Association, American Journal of Public Health, AIDS and Behavior, AIDS Care, Violence against Women, Journal of Community Psychology, and Journal of Interpersonal Violence. Dr. Frye is Associate Editor at the Journal of Urban Health.
Cynthia A. Gómez, PhD, is the founding director of the Health Equity Institute at San Francisco State University and Professor in the Department of Health Education. She previously served as co-director of the Center for AIDS Prevention Studies (CAPS) at the University of California at San Francisco and has been a leading scientist in HIV prevention research since 1991. Her work has focused primarily on gender, culture, and sexual health; on the development of prevention interventions; and on the translation of science to community practice. She has been a health policy advisor for nearly 20 years: Presidential Advisory Council on HIV/AIDS, California Public Health Advisory Council, Centers for Disease Control's HIV and STD Advisory Council, Substance Abuse and Mental Health Services Administration's Advisory Committee on Women's Services, and the Institute of Medicine's Committees on Prisoners and Research and on Lesbian Health. She has been a member and a past chair of the board of directors of the Guttmacher Institute and serves on several other boards of directors, including Public Responsibility in Medicine & Research, Planned Parenthood Shasta Pacific, and the San Francisco Public Health Foundation.
Mary Latka, PhD, MPH, is an epidemiologist who, for the last 15 years, has focused on testing technologies and strategies to prevent the heterosexual transmission of HIV. She earned her Masters and PhD in Epidemiology from the Mailman School of Public Health, Columbia University, New York City. She also completed post-doctoral training in HIV Prevention at the HIV Center for Clinical and Behavioral Studies, Columbia University. She is Assistant Clinical Professor of Epidemiology, Mailman School of Public Health, Columbia University, and has contributed over 50 peer-reviewed publications to the scientific field. After eight years of working in New York City on a dwindling HIV epidemic, and because of a strong desire to work on the front line of the HIV epidemic, she moved her entire family to South Africa. She joined The Aurum Institute in May 2007, as Programme Director for HIV Prevention, is based in Johannesburg, and her research is conducted at Aurum's research centers in Klerksdorp and Rustenburg. Now in the position of Senior Scientist, her work includes Phase III microbicides trials and a completed Phase IIB vaccine trial to evaluate their efficacy against primary HIV acquisition. Other work includes: a representative community survey of Rustenburg and, evaluation of selection biases associated with enrollment in clinical research for estimating the generalizability of findings from clinical trial, socio-behavioural factors associated with HIV testing male circumcision uptake, and pregnancy risk among HIV trial participants.
David W. Purcell, JD, PhD, is branch chief of the Prevention Research Branch, Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention in Atlanta, GA. His research has focused on HIV prevention interventions, particularly for HIV-positive persons and gay and bisexual men.
Amy R. Knowlton, ScD, is Associate Professor, Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health. Her research focus is the role of social support networks, informal care-giving relationships, and structural factors in HIV medical adherence among disadvantaged populations. Her research provides evidence of the role of social network structures and supportive functioning in drug use and gender disparities in HIV medication adherence and outcomes in the US.
Lisa Metsch, PhD, is Professor of Epidemiology and Public Health, Director of the Health Services Research and Policy Division, and also the Director of the Behavioral, Social Sciences and Community Outreach Core of the NIAID-funded Developmental Center for AIDS Research at the University of Miami Miller School Of Medicine. Her research interests include HIV prevention, behavioral interventions, women's health, oral health, substance abuse policy research, and access and use of health care services for vulnerable populations. Dr. Metsch is co-principal investigator of the Florida Node Alliance of the NIDA-funded Drug Abuse Clinical Trials Network and is currently leading several NIDA-funded clinical trials focusing on HIV testing and strategies to address the prevention and care needs of drug users living with HIV. She is also working on NIDCR-funded studies related to oral health and HIV.
Karin E. Tobin, PhD, MHS, is a social and behavioral scientist who has been conducting research with drug-using populations focused on HIV prevention, overdose prevention, and mental health issues. She is Associate Scientist in the Department of Health, Behavior and Society at the Johns Hopkins Bloomberg School of Public Health and her research activities include examinations of social network characteristics and role of social environmental factors on health.
Eduardo E. Valverde, MPH, is an Epidemiologist in the Behavioral and Clinical Surveillance Branch of the Division of HIV/AIDS Prevention Centers for Disease Control and Prevention. He has been involved in HIV/AIDS prevention, surveillance, and research activities at the community, state, and national levels since 1989. Currently, he leads a project intended to develop best practices to identify HIV-infected MSM (men who have sex with men) who were previously unaware of their HIV infection and link them to HIV medical care.
Kelly Ray Knight, PhD, is a medical anthropologist at the Department of Medicine's Positive Health Program and the Department of Anthropology, History and Social Medicine, University of California at San Francisco. Dr. Knight received her undergraduate degree from Georgetown University, her Master of Education from Harvard University and her PhD in Medical Anthropology from the joint UC-Berkeley and UCSF doctoral program in Medical Anthropology. Prior to joining the Positive Health Program in 2008, she conducted social-behavioral HIV prevention research for over a decade at the UCSF Center for AIDS Prevention Studies.