Facilitators, Barriers, and Solutions to Implementation of Peer Educator Intervention for Drug Using Individuals

Introduction:  HIV prevention peer education interventions have been shown to be effective at reducing HIV risk behaviors with a variety of at-risk populations such as drug users, adolescents, MSM, and sex workers, in different types of settings.  Since many community organizations that offer HIV prevention services often have limited resources, evidence-based peer educator interventions have great appeal as they reach beyond clients who come to the organizations.  However, little is known about the implementation of this type of interventions in community-based settings.   

Methods:  The SHIELD intervention is an intervention that trains drug using individuals to provide peer outreach on risk reduction.  Recognized by the CDC as an Evidence-based program, staff from over 50 agencies across the US has been trained on how to implement the SHIELD intervention. In this exploratory study, phone interviews were conducted with 1-2 staff members per agency that attended a SHIELD intervention training offered by the CDC between 2010-2012.  Semi-structured interviews focused on the status, facilitators, and barriers of implementation.  For each barrier named, participants were asked about strategies to overcome barriers.  

Results:  At the time of this submission, seven agencies who have implemented SHIELD have completed interviews.  Additional agencies are currently being recruited.  Among implementing agencies, facilitators of implementation included factors such as previous experience working with the population and having a network of community partners.  Common barriers focused characteristics of the intervention (i.e location, time allotment, and peer outreach component), working with the target population (i.e. recruitment and retention) and limited resources to implement the intervention.  Strategies that agencies used to overcome barriers will be discussed. 

Conclusion:  As initiatives focused on the uptake of evidence-based interventions increase, it is important to identify facilitators and barriers so that implementing agencies can be better prepared to implement and maintain these evidence-based interventions.