Evaluation of the Young Deadly Free Peer Education Training Program: Early Results, Methodological Challenges, and Learnings for Future Evaluations

Abstract

Australian Aboriginal and Torres Strait Islander people experience disproportionately higher rates of sexually transmissible infections (STIs) and blood borne viruses (BBVs) when compared with the non-Indigenous population. Both incidence and prevalence data for bacterial STIs, such as chlamydia, gonorrhea, trichomonas, and syphilis in remote areas of Australia are reported at rates many times higher than that of non-Indigenous Australians. Similarly, rates of hepatitis B are disproportionately higher for non-Indigenous people in remote communities. The Young Deadly STI and BBV Free project was designed to increase the uptake of STI and BBV testing and treatment in young Aboriginal and Torres Strait Islander people living in remote and very remote areas of South Australia, Western Australia, Queensland, and the Northern Territory. Peer education formed one component of this pilot project and involved training up to 100 young Aboriginal and Torres Strait Islander people across 19 communities in a culturally appropriate and respectful manner on the transmission, testing, and treatment of STIs and BBVs. The trained peer educators were then required to deliver three community education sessions to young people in their respective communities in an effort to raise awareness about STIs and BBVs and encourage testing and treatment uptake. Preliminary evaluation findings, limited to the trained peer educators, revealed the peer educator training program contributed to STI and BBV knowledge gains among the trained peer educators and positively influenced their behavioral intentions and attitudes pertaining to STIs and BBVs. Working with remote Aboriginal and Torres Strait Islander populations on a highly sensitive, stigmatized topic presented many methodological challenges, particularly in terms of ensuring the collection of reliable evaluation data across geographically remote communities. The challenges and strengths associated with the implementation of the peer education training program along with implications for developing culturally inclusive evaluation practices will be discussed.

Integrating testing for sexually transmissible infections into annual health assessments for Aboriginal and Torres Strait Islander young people: a cross-sectional analysis

“…The very high rate of integration of syphilis testing into CT/NG tests done as part of the health assessment is encouraging, as the infectious syphilis notification rate for Aboriginal and Torres Strait Islander people is highest in remote and very remote regions and has increased most rapidly among 20-29-year-olds. 33 Higher uptake of testing in very remote regions could reflect the impact of recent health promotion programs 34 and clinical initiatives 35 conducted in response to the ongoing syphilis outbreak in remote regions across northern Australia, 10,36 indicating that interventions to increase syphilis testing have been accurately targeted to those most at risk. However, lower levels of integration for syphilis in urban and regional areas and for HIV in urban areas is of concern, as syphilis notifications are increasing in these regions and HIV prevalence in Australia is greatest in metropolitan areas.…”

Practice and product: a social semiotic approach to visual communication in sexual and reproductive health promotion

“…There is also a great deal of literature on reproductive and sexual health issues amongst Aboriginal and Torres Strait Islander people – higher rates of STIs, blood-borne viruses, cervical cancer and unintended pregnancies, and lower rates of contraceptive use (e.g. D’Costa et al, 2019).…”

Effectiveness of a peer education gender and health project for men in Timor‐Leste

“…Although peer education is widely used in developing countries, evidence is varied regarding the efficacy of it as an intervention. [21][22][23][24] However, a number of evaluations of peer education programs in relation to HIV and sexual health attitudes and behaviour change have reported positive outcomes among different populations including among adolescents and young people, 25,26 Indigenous communities, [27][28][29] refugee communities 30,31 and rural communities. 32 While examples such as these highlight the potential value of peer education programs in different settings, both for the peer educators themselves and those they work with, less is known regarding the sustainability of these programs and longer-term effects for participants and the broader community.…”