Peer education has long been used to promote HIV awareness and reduce risk. However, little has been written about its use in refugee settings. This study aimed to assess whether refugee peer education could improve HIV knowledge, attitudes and practices among Guinean refugees. The study also assessed whether gender, age or formal education were more strongly associated to improved HIV outcomes than peer education. Data was collected through a cross-sectional survey of 889 men and women in 23 camps throughout the Forest Region, Guinea. Logistic regression odds ratios were calculcatedáfor analysis. The majority of respondents (88%) had heard of HIV, especially those exposed to the peer education or formal education. The majority could identify protective measures, but misconceptions about transmission persisted. Those exposed to peer or formal education had fewer misconceptions. Fifty percent of the respondents perceived themselves as at risk, with women having 52% higher odds than men of perceiving themselves as at risk (adjusted OR 1.52, 95%CI 1.01-2.29). Those exposed to peer education had two times the odds of havingáimproved their behavior to avoid HIV risk than those unexposed (72% versus 58%; adjusted OR 2.49, 95%CI 1.52-4.08). Women had 57% lower odds of reporting such behavioral changes than men (OR 0.43, 95%CI 0.31-0.60). However, women involved in peer education had greater odds than men also involved in peer education of reporting HIV avoidant behavioral changes. Remaining faithful was the most common reported behavioral change. Peer education was most strongly associated with reported behavior change to avoid HIV. Gender was most associated with HIV knowledge and risk perception. Women refugees were less likely to have misconceptions about HIV, but also less likely to change their behavior to avoid HIV and more likely to report being at risk for HIV than men. Gender disparities and barriers to condom use must be addressed alongside peer educational approaches in refugee settings.
Conflict and Health
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