Prevention with Positive Youth: Content and Design of an Innovative Peer Counselor Training Program for HIV+ Youth

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 adolescents based on Social Action Theory has been implemented at a teen clinic in the Southeastern U.S. Selection: Youth aged 18 to 24 were selected to match the likely race, gender, and sexual orientation of counselees. Teens who are caring, motivated, non-judgmental, dependable, positive, warm, and good communicators with a good sense of humor were invited to participate. Positive role models were preferred, but counselors in training (CITs) were not required to be 100% abstinent/condom-protected or medication-adherent. Training: The 5.5-day training addressed rapport-building, motivational interviewing, professionalism, HIV knowledge, sexual risk decision-making and reduction strategies, finding meaning/purpose, coping, worry/control, stigma/shame, guilt/forgiveness, medical adherence, stress-related growth, and self-care. Next, CITs complete a 2 to 4-month professionally supervised internship with mock counselees. Once trained, counselors provide individualized counseling for other HIV+ adolescents (ages 13-24). Study participants are compared to a wait-list control group. Participants complete an ACASI assessing quality of life, HIV knowledge, attitudes, and behaviors and provide biological samples for STD testing at baseline, before the intervention, and at 6-month follow-up intervals. LESSONS LEARNED: Adolescents are eager to share their stories with other HIV+ youth. Positive changes have been reported by study participants. RECOMMENDATIONS: Peer counseling by HIV+ youth is a novel and feasible prevention model. Programs that provide prevention with positive youth should consider including a peer counseling component.