Accessing Social Networks With High Rates of Undiagnosed HIV Infection: The Social Networks Demonstration Project

We evaluated the use of social networks to reach persons with undiagnosed HIV infection in ethnic minority communities and link them to medical care and HIV prevention services. Nine community-based organizations in 7 cities received funding from the Centers for Disease Control and Prevention to enlist HIV-positive persons to refer others from their social, sexual, or drug-using networks for HIV testing; to provide HIV counseling, testing, and referral services; and to link HIV-positive and high-risk HIV-negative persons to appropriate medical care and prevention services. From October 1, 2003, to December 31, 2005, 422 recruiters referred 3172 of their peers for HIV services, of whom 177 were determined to be HIV positive; 63% of those who were HIV-positive were successfully linked to medical care and prevention services. The HIV prevalence of 5.6% among those recruited in this project was significantly higher than the approximately 1% identified in other counseling, testing, and referral sites funded by the Centers for Disease Control and Prevention. This peer-driven approach is highly effective and can help programs identify persons with undiagnosed HIV infection in high-risk networks.