The Effectiveness of a Peer-Led HIV/AIDS and STI Health Education Intervention for Prison Inmates in South Africa

Sifunda, Sibusiso; Reddy, Priscilla; Braithwaite, Ronald L.; Stephens, Torrance; Bhengu, Sibusisiwe; Ruiter, Rob; Borne, Bart van den

doi:10.1177/1090198106294894

Cited by 34 publications

(65 citation statements)

References 13 publications

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“…38,121,136,138,139 Nineteen were of moderate quality 25,31,37,101,106,[126][127][128][131][132][133]135,137,140,147,148,151,161,162 and 32 were of poor quality. 23,27,32,36,119,120,[122][123][124][125]129,130,134,[141][142][143][144][145][146]149,150,[152][153][154][155][156][157][158]…”

Section: Description Of Included Studiesmentioning

confidence: 99%

“…23,25,123,124,126,135,136,138,139,147,151,153,155,156 Peer education was the most studied intervention mode (21 studies). 23,27,101,106,120,121,123,125,126,[128][129][130][131]134,143,144,[158][159][160]162,164 Of the other studies 14 were on peer support, 25,26,32,38,140,[149][150][151][152][153][154][155][156][157] two were on peer advisors, 135,139 two were on health trainers, …”

Section: Description Of Included Studiesmentioning

confidence: 99%

“…25,31,32,37,38,[135][136][137][138][139][140][141][142][143][144][145][146][147][148][149] Other countries represented were Canada, 26,36,[150][151][152][153][154][155][156] Australia, 157,158 Ireland,159 the Russian Federation, 160 Israel, 161 South Africa, 162 the Republic of Moldova, 163 and Mozambique 164 ( Table 1).…”

Section: Description Of Included Studiesmentioning

confidence: 99%

“…They then deliver (1) formal educational/behaviour change interventions, for example risk reduction planning, 27 and/or (2) engage in informal education and awareness raising through social interactions with fellow prisoners within the prison. 106 Eighteen studies 23,27,101,106,123,126,[129][130][131]134,143,144,[158][159][160][161][162]164 contained quantitative findings about the effects of peer education on prisoner health. Of these, 12 23,27,101,106,123,126,130,131,158,160,162,164 were on HIV/AIDS prevention, one 134 was on hepatitis C prevention, one 144 was on the prevention of infectious diseases in general, one 159 was on health and hygiene, one 161 was on general and mental health, one 129 was on parenting and one 143 was on literacy.…”

Section: Peer Educationmentioning

confidence: 99%

“…A total of 16 studies gave details of the underpinning theoretical model for the intervention 38,101,106,126,130,131,134,150,151,[153][154][155][156][161][162][163] In total, 19 studies had a quantitative design, 23,27,101,106,[122][123][124]126,130,132,134,143,144,146,154,[160][161][162]164 16 had a qualitative design 31,38,119,121,125,128,[137][138][139][140]142,147,148,150,159,…”

Section: Description Of Included Studiesmentioning

confidence: 99%

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A systematic review of the effectiveness and cost-effectiveness of peer-based interventions to maintain and improve offender health in prison settings

South

Bagnall

Hulme

et al. 2014

Health Services and Delivery Research

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BackgroundOffender health is deemed a priority issue by the Department of Health. Peer support is an established feature of prison life in England and Wales; however, more needs to be known about the effectiveness of peer-based interventions to maintain and improve health in prison settings.ObjectivesThe study aimed to synthesise the evidence on peer-based interventions in prison settings by carrying out a systematic review and holding an expert symposium. Review questions were (1) what are the effects of peer-based interventions on prisoner health and the determinants of prisoner health?, (2) what are the positive and negative impacts on health services within prison settings of delivering peer-based interventions?, (3) how do the effects of peer-based approaches compare with those of professionally led approaches? and (4) what are the costs and cost-effectiveness of peer-based interventions in prison settings?Data sourcesFor the systematic review, 20 electronic databases including MEDLINE, PsycINFO, the Cumulative Index to Nursing and Allied Health Literature and EMBASE were searched from 1985. Grey literature and relevant websites were also searched. To supplement the review findings 58 delegates, representing a variety of organisations, attended an expert symposium, which provided contextual information.Review methodsTwo reviewers independently selected studies using the following inclusion criteria: population – prisoners resident in prisons and young offender institutions; intervention – peer-based interventions; comparators: review questions 3 and 4 compared peer-led and professionally led approaches; outcomes – prisoner health or determinants of health, organisational/process outcomes or views of prison populations; study design: quantitative, qualitative and mixed-methods evaluations. Two reviewers extracted data and assessed validity using piloted electronic forms and validity assessment criteria based on published checklists. Results from quantitative studies were combined using narrative summary and meta-analysis when appropriate; results from qualitative studies were combined using thematic synthesis.ResultsA total of 15,320 potentially relevant papers were identified of which 57 studies were included in the effectiveness review and one study was included in the cost-effectiveness review; most were of poor methodological quality. A typology of peer-based interventions was developed. Evidence suggested that peer education interventions are effective at reducing risky behaviours and that peer support services provide an acceptable source of help within the prison environment and have a positive effect on recipients; the strongest evidence came from the Listener scheme. Consistent evidence from many predominantly qualitative studies suggested that being a peer deliverer was associated with positive effects across all intervention types. There was limited evidence about recruitment of peer deliverers. Recurring themes were the importance of prison managerial and staff support for schemes to operate successfully, and risk management. There was little evidence on the cost-effectiveness of peer-based interventions. An economic model, developed from the results of the effectiveness review, although based on data of variable quality and a number of assumptions, showed the cost-effectiveness of peer-led over professionally led education in prison for the prevention of human immunodeficiency virus (HIV) infection.LimitationsThe 58 included studies were, on the whole, of poor methodological quality.ConclusionsThere is consistent evidence from a large number of studies that being a peer worker is associated with positive health. Peer support services can also provide an acceptable source of help within the prison environment and can have a positive effect on recipients. This was confirmed by expert evidence. Research into cost-effectiveness is sparse but a limited HIV-specific economic model, although based on a number of assumptions and evidence of variable quality, showed that peer interventions were cost-effective compared with professionally led interventions. Well-designed intervention studies are needed to provide robust evidence including assessing outcomes for the target population, economic analysis of cost-effectiveness and impacts on prison health services. More research is needed to examine issues of reach, utilisation and acceptability from the perspective of recipients and those who choose not to receive peer support.Study registrationThis study was registered as PROSPERO CRD42012002349.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

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