Training HIV+ Young People for Peer Counseling: Lessons and Recommendations

ISSUES: The prevalence of HIV infection among adolescents/young adults is substantial. Innovative strategies for enhancing prevention practices among HIV+ youth are urgently needed. DESCRIPTION: A peer counseling program for behaviorally HIV-infected youth based on Social Action Theory has been implemented at a primary care teen clinic in Atlanta. Peer counselors undergo a 5.5-day training and a 2 to 4-month internship. Once trained, the counselors provide individual counseling for HIV+ youths (ages 13-24). Study participants are compared to a wait-list control group of counselees. Audio-computer assisted self interview (A-CASI) surveys that include validated knowledge, attitude, behavior, and biological measures are completed by study participants at baseline, before the intervention, and at 6-month intervals. LESSONS LEARNED: Counselees often express a hunger to tell their stories to another HIV+ youth. CITs showed surprisingly high levels of counseling skills, quality of life scores, etc. prior to training as well as low levels of risk-taking behavior. Both counselors in training (CITs) and counselees have responded enthusiastically to the program. Positive changes have been reported by study participants. Problems encountered included retention, scheduling, housing, mental health, employment, childcare, etc. RECOMMENDATIONS: Peer counseling by HIV+ youth is a novel and feasible secondary prevention model. Programs that train youth peer counselors should involve a wide variety of professional social and health care workers, recruit youth that lead less fractured lives, provide assistance in transportation, childcare, etc. They should also schedule activities at non-traditional times that fit the unstable schedules of teens and plan for higher than normal attrition.