A Pilot Test of Game Changers, a Social Network Intervention to Empower People with HIV to be Prevention Advocates in Uganda

We conducted a pilot randomized controlled trial of Game Changers , a 6-session group intervention that empowers people with HIV to be HIV prevention advocates in their social networks. Ninety-nine people with HIV (51 intervention, 48 wait-list control) and 58 of their social network members (alters...

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Bibliographic Details
Published in:AIDS and behavior 2020-09, Vol.24 (9), p.2490-2508
Main Authors: Bogart, Laura M., Matovu, Joseph K. B., Wagner, Glenn J., Green, Harold D., Storholm, Erik D., Klein, David J., Marsh, Terry, MacCarthy, Sarah, Kambugu, Andrew
Format: Article
Language:English
Subjects:
Adolescent
Adult
Disease prevention
Empowerment
Female
Health Promotion - methods
Health Psychology
HIV
HIV Infections - prevention & control
HIV Infections - psychology
Human immunodeficiency virus
Humans
Infectious Diseases
Intervention
Male
Medicine
Medicine & Public Health
Original Paper
Patient Participation
Pilot Projects
Prevention
Public Health
Sexually transmitted diseases
Social interactions
Social Networking
Social networks
Social organization
Social Stigma
STD
Stigma
Uganda
Young Adult
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Summary:We conducted a pilot randomized controlled trial of Game Changers , a 6-session group intervention that empowers people with HIV to be HIV prevention advocates in their social networks. Ninety-nine people with HIV (51 intervention, 48 wait-list control) and 58 of their social network members (alters) completed baseline and 5- and 8-month post-baseline assessments. Results indicated high acceptability, demonstrated by participants’ and facilitators’ positive attitudes qualitatively and favorable ratings of intervention sessions quantitatively, and high feasibility (76% attended all intervention sessions). Intention-to-treat analyses indicated significantly increased HIV prevention advocacy among HIV-positive participants and alters [b (SE) = 0.4 (0.2), p = .017; b (SE) = 0.4 (0.2), p = .035]; reduced internalized HIV stigma [b (SE) =  − 0.3 (0.1), p = .012], increased HIV-serostatus disclosure [b (SE) = 0.1 (0.1), p = .051], and increased social network density among HIV-positive participants [b (SE) = 0.1 (0.03), p = .004]; and marginally reduced condomless sex among alters [OR (95% CI) = 0.3 (0.1–1.2), p = .08]. Positioning people with HIV as central to prevention has the potential to reduce stigma and improve prevention outcomes throughout social networks.
ISSN:1090-7165
1573-3254
DOI:10.1007/s10461-020-02806-4