Cited by 737HIV/AIDS Research and InterventionsHIV, Drug Use, Sexual RiskAdolescent Sexual and Reproductive Health

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HIV risk behavior reduction following intervention with key opinion leaders of population: an experimental analysis.

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Kelly, J A, St Lawrence, J S, Diaz, Y E, Stevenson, L Y, Hauth, A C, Brasfield, T L, Kalichman, S C, Smith, J E, Andrew, M E·1991·American Journal of Public Health

DOI 10.2105/ajph.81.2.168PMC PMC1404968

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Abstract

BACKGROUND AND PURPOSE. Peer norms influence the adoption of behavior changes to reduce risk for HIV (human immunodeficiency virus) infection. By experimentally intervening at a community level to modify risk behavior norms, it may be possible to promote generalized reductions in HIV risk practices within a population. METHODS. We trained persons reliably identified as popular opinion leaders among gay men in a small city to serve as behavior change endorsers to their peers. The opinion leaders acquired social skills for making these endorsements and complied in talking frequently with friends and acquaintances. Before and after intervention, we conducted surveys of men patronizing gay clubs in the intervention city and in two matched comparison cities. RESULTS. In the intervention city, the proportion of men who engaged in any unprotected anal intercourse in a two-month period decreased from 36.9 percent to 27.5 percent (-25 percent from baseline), with a reduction from 27.1 percent to 19.0 percent (-30 percent from baseline) for unprotected receptive anal intercourse. Relative to baseline levels, there was a 16 percent increase in condom use during anal intercourse and an 18 percent decrease in the proportion of men with more than one sexual partner. Little or no change was observed among men in the comparison cities over the same period of time. CONCLUSIONS. Interventions that employ peer leaders to endorse change may produce or accelerate population behavior changes to lessen risk for HIV infection.

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Psychological factors that predict AIDS high-risk versus AIDS precautionary behavior.
Kelly, J. A., Lawrence, J. S. S., Brasfield, T. L., Lemke, A., Amidei, T., Roffman, R. E., Hood, H. V., Smith, J. E., Kilgore, H., & McNeill, C. (1990) · Journal of Consulting and Clinical Psychology · doi:10.1037//0022-006x.58.1.117 · Cited by 183
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Sexual Violence in Young People: A Systematic Literature Review of Prevention Programmes
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“According to social norms theory (Perkins & Berkowitz, 1986) and the peer influence model (Kelly et al., 1991), having influential, prosocial and trained peers may increase the likelihood of interventions being effective.”
Social Networks of HIV Positive Gay Men: Their Role and Importance in HIV Prevention
Tobin, K. E., & Latkin, C. A. (2017) · Springer eBooks · doi:10.1007/978-1-4419-0203-0_15 · Cited by 11
Identification of Key Influencers for Secondary Distribution of HIV Self-Testing Kits Among Chinese Men Who Have Sex With Men: Development of an Ensemble Machine Learning Approach
Jing, F., Ye, Y., Zhou, Y., Ni, Y., Yan, X., Lu, Y., Ong, J. J., Tucker, J. D., Wu, D., Xiong, Y. Y., et al. (2023) · Journal of Medical Internet Research · doi:10.2196/37719 · Cited by 11
“First, some studies selected key influential people based on human intuition and then trained them as opinion leaders [11,12].”
Communication Expressed on the COVID-19 Subreddit in the Midst of a Global Pandemic
Britt, R. K., Britt, B., Panek, E. T., & Lee, J. (2021) · Health Communication · doi:10.1080/10410236.2021.1994190 · Cited by 11
“Considering that users were uniquely knowledgeable about COVID-19 relative to the average individual, they may have represented opinion leaders (Kelly et al., 1991) gleaning information that could then be shared with their respective peer groups.”
Background
The stability of youth popular opinion leaders selected over time using social network analysis
Waterman, E. A., Edwards, K. M., Keyes, A. B., Zulfiqar, H., Banyard, V. L., & Valente, T. W. (2022) · American Journal of Community Psychology · doi:10.1002/ajcp.12595 · Cited by 11
Cost-Effectiveness Analysis
Gift, T. L., & Marrazzo, J. M. (2007) · Springer eBooks · doi:10.1007/978-0-387-48740-3_21 · Cited by 11
Community trial of insecticide-treated bed net use promotion in southern Ghana: the Net Use Intervention study
Elder, J. P., Botwe, A. A., Selby, R. A., Franklin, N., & Shaw, W. D. (2011) · Translational Behavioral Medicine · doi:10.1007/s13142-011-0032-4 · Cited by 11
“Corresponding to the advent of the AIDS epidemic [5] and the globalization of other health problems, however, researchers in behavioral medicine (e.”
Background
Student Opinion Leaders and HIV/AIDS Knowledge and Risk Behavior
Jaccard, J. J., Levinson, R. A., & Beamer, L. J. (1995) · Journal of American College Health · doi:10.1080/07448481.1995.9940479 · Cited by 11
Preventing the sexual transmission of HIV: Current status and future directions
O'Leary, A., & Raffaelli, M. (1996) · Psychology and Health · doi:10.1080/08870449608401977 · Cited by 9
Practical Prevention Issues
Ostrow, D. G. (2005) · Kluwer Academic Publishers eBooks · doi:10.1007/0-306-47159-0_7 · Cited by 11
“Kelly and colleagues have developed a model for such interventions in their multiple smallcity studies which utilize community opinion leaders, usually bartenders and other gay venue personalities, to deliver the message that safer sex is the necessary norm for the community (Kelly et al., 1991; Kelly et al., 1992).”
Background
Design and integration of ethnography within an international behavior change HIV/sexually transmitted disease prevention trial
(2007) · AIDS · doi:10.1097/01.aids.0000266456.03397.d3 · Cited by 10
Dynamics of Social Influence and Knowledge in Networks: Sociophysics Models and Applications in Social Trading, Behavioral Finance and Business
Tsintsaris, D., Tsompanoglou, M., & Ioannidis, E. (2024) · Mathematics · doi:10.3390/math12081141 · Cited by 10
Diffusion of Effective Behavioral Interventions and Hispanic/Latino Populations
Stallworth, J. M., Andía, J. F., Burgess, R., Alvarez, M. E., & Collins, C. B. (2009) · AIDS Education and Prevention · doi:10.1521/aeap.2009.21.5_supp.152 · Cited by 10
Health Education – Responsibility – Changing Attitude. A New Pedagogical and Methodological Concept of Peer Education
Feith, H. J., Ágnes Lukács, J., Gradvohl, E., Füzi, R., Darvay, S., Krekó, I. B., & Falus, A. (2018) · Acta Universitatis Sapientiae Social Analysis · doi:10.2478/aussoc-2018-0004 · Cited by 10
A Social Network Analysis of Cooperation and Support in an HIV Service Delivery Network for Young Latino MSM in Miami
Kanamori, M., Williams, M. L., Fujimoto, K., Shrader, C., Schneider, J. A., & Rosa, M. R. D. L. (2019) · Journal of Homosexuality · doi:10.1080/00918369.2019.1667160 · Cited by 10
“Social network methodologies have found that HIV risk behavior reduction may be facilitated through peer networks and popular opinion leaders (Kelly et al., 1991; Valente & Davis, 1999).”
Background
HIV treatments as prevention (TasP) : primer for behavior-based implementation
Kalichman, S. C. (2013) · DIAL (Catholic University of Leuven) · doi:10.1007/978-1-4614-5119-8 · Cited by 10
Self-citation
HIV Prevention in India: Focus on Men, Alcohol Use and Social Networks
Sivaram, S., Latkin, C. A., Solomon, S., & Celentano, D. D. (2006) · Cited by 10
Brief Report: Quantitative Assessment of Brief Messages About HIV Pre-exposure Prophylaxis Among HIV-Infected and HIV-Uninfected Black/African American and Hispanic/Latino MSM
Mansergh, G., Baack, B. N., Holman, J., Mimiaga, M. J., Landers, S., & Herbst, J. H. (2018) · JAIDS Journal of Acquired Immune Deficiency Syndromes · doi:10.1097/qai.0000000000001869 · Cited by 10
Challenges and processes of selecting outcome measures for the NIMH Collaborative HIV/STD Prevention Trial
NIMH Collaborative HIV/STD Prevention Trial Group (2007) · AIDS · doi:10.1097/01.aids.0000266455.03397.08 · Cited by 10
The use of popular opinion leader (POL) groups and the reduction of ‘Gay bullying’ in middle school: A case study inquiry of group leader experiences
Singh, A. A. (2013) · The Journal for Specialists in Group Work · doi:10.1080/01933922.2013.800177 · Cited by 9
Lessons Learned: Achieving Critical Mass in Masking Among Youth in Congregate Living
Davies, S., Porta, A. D., Renjilian, C. B., Sit, L., & Ginsburg, K. R. (2020) · Journal of Adolescent Health · doi:10.1016/j.jadohealth.2020.05.001 · Cited by 9
Men who have sex with men: An approach to social network analysis
Marqués‐Sánchez, P., Bermejo‐Martínez, D., Sánchez, E. Q., Calvo‐Ayuso, N., Liébana‐Presa, C., & Benítez‐Andrades, J. A. (2022) · Public Health Nursing · doi:10.1111/phn.13138 · Cited by 8
“…perspective emphasizes that both prevention and sexual behaviors are formed in settings throughprocessesof peer influence, social norms, and structural positionwithin the network, as social context is seen as a critical factor influencing sexual behaviors (Kelly et al., 1991; Shah et al., 2014).”
Background
Optimal allocation of HIV prevention funds for state health departments
Yaylalı, E., Farnham, P. G., Cohen, S. M., Purcell, D. W., Hauck, H., & Sansom, S. L. (2018) · PLoS ONE · doi:10.1371/journal.pone.0197421 · Cited by 9
Influencers as socio-technical actors: mapping the paths of influence and the traces of the digital influencers’ system in Italy
Locatelli, E. (2021) · Journal of Sociocybernetics · doi:10.26754/ojs_jos/jos.202013940 · Cited by 13
“A similar terminology was used in studies about offline communities (Kelly et al., 1991).”
Method
[Knowledge and Self Efficacy Related with HIV Prevention among Chilean Women].
Villegas, N., Ferrer, L., Acosta, R. C., Miner, S. M., Campos, L. L., & Peragallo, N. P. (2011) · PubMed · Cited by 9
Identifying Opinion Leaders for Marketing by Analyzing Online Social Networks
Momtaz, N. J., Aghaie, A., & Alizadeh, S. (2011) · International Journal of Virtual Communities and Social Networking · doi:10.4018/jvcsn.2011070102 · Cited by 9
Interventions to Prevent Suicidal Behavior
Knox, K. L. (2007) · Springer eBooks · doi:10.1007/978-0-387-29457-5_10 · Cited by 9
Three models to promote syphilis screening and treatment in a high risk population
Geringer, W. M., & Hinton, M. (1993) · Journal of Community Health · doi:10.1007/bf01325158 · Cited by 9
Are we going to close social gaps in HIV? Likely effects of behavioral HIV-prevention interventions on health disparities
Albarracín, D., & Durantini, M. R. (2010) · Psychology Health & Medicine · doi:10.1080/13548506.2010.498892 · Cited by 9
Structural Interventions
Bloom, F. R., & Cohen, D. A. (2007) · Springer eBooks · doi:10.1007/978-0-387-48740-3_5 · Cited by 9
Behavioural economics and health
Kessler, J. B., & Zhang, C. Y. (2015) · doi:10.1093/med/9780199661756.003.0130 · Cited by 10
Sex education and HIV/AIDS prevention
Gillies, P. (1994) · Sexual and Marital Therapy · doi:10.1080/02674659408409578 · Cited by 11
Emerging Behavioral Strategies for the Prevention of HIV in Rural Areas
Lawrence, J. S. S. (1999) · The Journal of Rural Health · doi:10.1111/j.1748-0361.1999.tb00755.x · Cited by 9
Social Media Communication and Network Correlates of HIV Infection and Transmission Risks Among Black Sexual Minority Men: Cross-sectional Digital Epidemiology Study
Young, L. E., Tang, J. L., & Nan, Y. (2022) · JMIR Formative Research · doi:10.2196/37982 · Cited by 8
“Finally, with their emphasis on individual risk behaviors, survey- and interview-based surveillance methods are not well suited to observe the social contexts that nurture behavioral risk, such as social networks [24], social and behavioral norms [25], and peer-group dynamics [26].”
Background
Dissemination, Implementation, and Adaptation of Evidence-based Behavioral HIV-Prevention Interventions Through Community Engagement: The US Centers for Disease Control and Prevention (CDC) Experience
Collins, C. B., & Tomlinson, H. L. (2014) · Springer eBooks · doi:10.1007/978-1-4939-0900-1_11 · Cited by 8
Behavioral Mechanisms in HIV Epidemiology and Prevention: Past, Present, and Future Roles
Bingenheimer, J. B., & Geronimus, A. T. (2009) · Studies in Family Planning · doi:10.1111/j.1728-4465.2009.00202.x · Cited by 8
“Still others developed and evaluated behavioral interventions targeting these psychosocial antecedents (Rickert et al. 1990; Kelly et al. 1991; Jemmott et al. 1992; Kipke et al. 1993; St. Lawrence et al. 1995).”
Background
Engaging Young Men as Community Health Leaders in an STI and Intimate Partner Violence Prevention Trial in Dar es Salaam, Tanzania
Kajula, L. J., Kilonzo, M. N., Conserve, D. F., Mwikoko, G., Kajuna, D., Balvanz, P., Yamanis, T. J., Mulawa, M. I., Hill, L. M., Mbwambo, J. K. K., et al. (2019) · Global Social Welfare · doi:10.1007/s40609-018-00134-z · Cited by 8
Network insiders and observers: who can identify influential people?
Gomila, R., Shepherd, H. R., & Paluck, E. L. (2020) · Behavioural Public Policy · doi:10.1017/bpp.2020.8 · Cited by 8
“The individuals identified by the observers (bartenders) were then recruited to become peer leaders in an effort to change sexual practices (Kelly et al., 1991).”
Background
The First 40 Years of AIDS: Promising Programs, Limited Success
Darrow, W. W. (2021) · AIDS and Behavior · doi:10.1007/s10461-021-03497-1 · Cited by 8
“Little or no change was observed among men in two comparison cities over the same 2 months [54].”
Background

Authors: Kelly, J. A., St Lawrence, J. S., Diaz, Y. E., Stevenson, L. Y., Hauth, A. C., Brasfield, T. L., Kalichman, S. C., Smith, J. E., & Andrew, M. E.
Affiliations: University of Mississippi Medical Center (US)
ORCID: Kelly, J A
Kalichman, S C
Smith, J E
Venue: American Journal of Public Health
Publisher: American Public Health Association
Published: 1991-02
Volume: 81
Issue: 2
Pages: 168-171
ISSN: 0090-0036 (ISSN-L)
1541-0048
DOI: 10.2105/ajph.81.2.168
PMC: PMC1404968
OpenAlex: W2012749243
Cited by: 736
References: 10
Citations by year: 2026: 9 · 2025: 7 · 2024: 14 · 2023: 7 · 2022: 22 · 2021: 17 · 2020: 17 · 2019: 19 · 2018: 26 · 2017: 25 · 2016: 17 · 2015: 30 · 2014: 31 · 2013: 28 · 2012: 29
FWCI: 19.99
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: American Journal of Public Health (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Funders: National Institutes of Health (5r01mh042908-11)
National Institute of Mental Health (R01 MH 42908)
Topics: Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Adolescent Sexual and Reproductive Health
Keywords: HIV risk behavior, peer leaders, opinion leaders, gay men, unprotected anal intercourse, condom use, sexual partners, peer norms, community-based intervention, HIV prevention, gay clubs
MeSH terms: Community Participation, Health Education, Homosexuality, Humans, Male, Risk Factors, Sexual Behavior, HIV Infections

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HIV risk behavior reduction following intervention with key opinion leaders of population: an experimental analysis.

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