Social Network Strategies to Address HIV Prevention and Treatment Continuum of Care among At-Risk and HIV-Infected Substance Users: A Systematic Scoping Review

May 2017 - Structural Prevention

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Ghosh, D., Krishnan, A., Gibson, B., et al. AIDS and Behavior (April 2017), 21(4):1183-1207. doi:10.1007/s10461-016-1413-y.

This systematic review described the advantages and disadvantages of social network-based interventions (SNI) for addressing HIV and outlined gaps for SNI use in the HIV continuum. The authors identified 58 studies published from the 1990s through 2014 that focused on HIV in substance users that had utilized social network analysis (SNA) or SNI as part of their methodology. The majority of studies (43) used SNA, but used this approach to facilitate or confirm a broader analysis rather than focusing on the networks. Only 13 studies used SNI. All 13 of the SNI studies implemented variants of peer-driven interventions; of these, the 9 that included controls showed substantial improvements in more than one HIV risk reduction behavior. The study revealed several challenges of SNIs: the potential for contamination; rapid network turnover, which might impede diffusion of interventions; concerns about the accuracy of peer-distributed information; and disclosure dynamics. The authors concluded that SNIs are cost-effective for reaching larger populations, including hard-to-reach groups, and enable members of key groups to serve as role models. They advocated for research to explore social network dynamics and optimize their potential to reduce HIV transmission and improve HIV care.

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