学术文献库

Each year, there are nearly 4 million youth experiencing homelessness (YEH) in the United States with HIV prevalence ranging from 3 to 11.5%. Peer change agent (PCA) models for HIV prevention have been used successfully in many populations, but there have been notable failures. In recent years, network interventionists have suggested that these failures could be attributed to PCA selection procedures. The change agents themselves who are selected to do the PCA work can often be as important as the messages they convey. To address this concern, we tested a new PCA intervention for YEH, with three arms: (1) an arm using an artificial intelligence (AI) planning algorithm to select PCA, (2) a popularity arm--the standard PCA approach--operationalized as highest degree centrality (DC), and (3) an observation only comparison group (OBS). PCA models that promote HIV testing, HIV knowledge, and condom use are efficacious for YEH. Both the AI and DC arms showed improvements over time. AI-based PCA selection led to better outcomes and increased the speed of intervention effects. Specifically, the changes in behavior observed in the AI arm occurred by 1 month, but not until 3 months in the DC arm. Given the transient nature of YEH and the high risk for HIV infection, more rapid intervention effects are desirable.