HIV prevention through social networks: evidence from a randomized controlled trial of a peer advocacy intervention in Kampala, Uganda

In a secondary analysis from a randomized controlled trial of a peer advocacy training intervention for people living with HIV (PLWH), we examined effects on advocacy targeting specific HIV protective behaviors among enrolled social network members (alters), and whether alter behaviors were predicted by advocacy receipt and tone of delivery. 210 PLWH and 599 alters enrolled and were followed over 18 months. Repeated measures logistic regressions showed that PLWH in the intervention group targeted more alters with advocacy for HIV testing, condom use, pre-exposure prophylaxis, and HIV care, compared to those in the control group. Alters targeted with HIV testing advocacy were more likely to report increased HIV testing at the subsequent assessment. Among alters with HIV-negative main partners, receipt of condom use advocacy predicted increased consistent condom use at the subsequent assessment. Advocacy training for PLWH can increase targeted HIV prevention advocacy, which then promotes HIV testing and condom use.