Network Insights into Implementing Peer-Based HIV Prevention for Homeless Youth

Objectives: Network-based HIV prevention models like POL promote HIV testing. Implementation of POL has proven challenging in some contexts. To inform implementation, we examined two networks of runaway and homeless youth (RHY) overtime to assess how social ties impacted HIV testing practices.

Methods: Data were collected from two populations of RHY recruited from drop-in centers in Los Angeles, every six months for one year (Network 1: n= 237, 263, 312; Network 2: n=138, 149, 131). For each panel a sociomatrix was generated based on youth nominating other youth in the sample.  Eigenvector centrality, which models prominence with respect to direct and indirect ties, was used to assess if more network centrality was associated with reports of  past 6-month HIV testing.

Results: In both networks, a consistent structure was observed overtime despite high turnover in individual membership in the networks. For network 1, 44% returned in panel 2, and 42% repeated between panels 2 and 3. For network 2, 18% returned in panel 2, and 14% repeated between panel 2 and 3. In Network 1, more central positions were associated with increased reports of recent HIV testing in all waves and in wave 2 and 3 for Network 2.

Conclusions: Despite the transience of particular network members over time, highly central positions in RHY networks are consistently occupied by youth who reported more HIV testing. Network-based HIV prevention interventions that target HIV testing,  such as POL, may be effectively implemented if highly central RHY are recruited as peer leaders.