{"id":18550,"date":"2025-06-19T10:37:17","date_gmt":"2025-06-19T14:37:17","guid":{"rendered":"https:\/\/www.med.unc.edu\/cfar\/?p=18550"},"modified":"2025-06-19T10:37:17","modified_gmt":"2025-06-19T14:37:17","slug":"understanding-the-peer-paradox-to-improve-hiv-services-for-black-sexual-and-gender-minorities","status":"publish","type":"post","link":"https:\/\/www.med.unc.edu\/cfar\/2025\/06\/understanding-the-peer-paradox-to-improve-hiv-services-for-black-sexual-and-gender-minorities\/","title":{"rendered":"Understanding the \u201cPeer Paradox\u201d to Improve HIV Services for Black Sexual and Gender Minorities"},"content":{"rendered":"<p><span data-contrast=\"none\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-18551\" src=\"https:\/\/www.med.unc.edu\/cfar\/wp-content\/uploads\/sites\/1380\/2025\/06\/HIV-Views-and-Social-Media-June-20.png\" alt=\"\" width=\"1567\" height=\"651\" srcset=\"https:\/\/www.med.unc.edu\/cfar\/wp-content\/uploads\/sites\/1380\/2025\/06\/HIV-Views-and-Social-Media-June-20.png 1567w, https:\/\/www.med.unc.edu\/cfar\/wp-content\/uploads\/sites\/1380\/2025\/06\/HIV-Views-and-Social-Media-June-20-300x125.png 300w, https:\/\/www.med.unc.edu\/cfar\/wp-content\/uploads\/sites\/1380\/2025\/06\/HIV-Views-and-Social-Media-June-20-1024x425.png 1024w, https:\/\/www.med.unc.edu\/cfar\/wp-content\/uploads\/sites\/1380\/2025\/06\/HIV-Views-and-Social-Media-June-20-768x319.png 768w, https:\/\/www.med.unc.edu\/cfar\/wp-content\/uploads\/sites\/1380\/2025\/06\/HIV-Views-and-Social-Media-June-20-1536x638.png 1536w, https:\/\/www.med.unc.edu\/cfar\/wp-content\/uploads\/sites\/1380\/2025\/06\/HIV-Views-and-Social-Media-June-20-600x249.png 600w\" sizes=\"auto, (max-width: 1567px) 100vw, 1567px\" \/>A recent qualitative study conducted by Carol Golin, Eunice Okumu, members of the CFAR\u2019s Social, Behavioral, and Implementation Sciences (SBIS) Core, as well as Ann Dennis, the co-leader of the UNC CFAR Scientific Working Group explored key challenges and opportunities in implementing an <\/span><i><span data-contrast=\"none\">enhanced Social Network Strategy (eSNS)<\/span><\/i><span data-contrast=\"none\"> to expand HIV prevention and care access among Black sexual and gender minority (BSGM) populations in the U.S. South\u2014a group disproportionately impacted by HIV. The study was conducted in an <\/span><i><span data-contrast=\"none\">Ending the HIV Epidemic (EHE)<\/span><\/i><span data-contrast=\"none\"> priority jurisdiction and included interviews and focus groups with HIV service providers, health department officials, and community-based organization leaders. Using the Consolidated Framework for Implementation Research (CFIR), researchers identified three central \u201cPeer Paradoxes\u201d related to trust within social networks:<\/span><span data-ccp-props=\"{&quot;134233117&quot;:false,&quot;134233118&quot;:false,&quot;201341983&quot;:0,&quot;335551550&quot;:1,&quot;335551620&quot;:1,&quot;335559738&quot;:240,&quot;335559739&quot;:240,&quot;335559740&quot;:279}\">\u00a0<\/span><\/p>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"31\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\uf0b7&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" data-aria-posinset=\"3\" data-aria-level=\"1\"><b><span data-contrast=\"none\">The Incentives Paradox:<\/span><\/b><span data-contrast=\"none\"> Financial incentives can strengthen peer engagement but may also risk making interactions feel transactional.<\/span><span data-ccp-props=\"{&quot;134233117&quot;:false,&quot;134233118&quot;:false,&quot;201341983&quot;:0,&quot;335551550&quot;:1,&quot;335551620&quot;:1,&quot;335559738&quot;:240,&quot;335559739&quot;:240,&quot;335559740&quot;:279}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"31\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\uf0b7&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" data-aria-posinset=\"4\" data-aria-level=\"1\"><b><span data-contrast=\"none\">The Readiness Paradox:<\/span><\/b><span data-contrast=\"none\"> Individuals best positioned to reach peers often need the most support to effectively deliver the intervention.<\/span><span data-ccp-props=\"{&quot;134233117&quot;:false,&quot;134233118&quot;:false,&quot;201341983&quot;:0,&quot;335551550&quot;:1,&quot;335551620&quot;:1,&quot;335559738&quot;:240,&quot;335559739&quot;:240,&quot;335559740&quot;:279}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"31\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\uf0b7&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" data-aria-posinset=\"5\" data-aria-level=\"1\"><b><span data-contrast=\"none\">The Credibility Paradox:<\/span><\/b><span data-contrast=\"none\"> While peers may be trusted personally, they may not be viewed as reliable sources of HIV-related information.<\/span><span data-ccp-props=\"{&quot;134233117&quot;:false,&quot;134233118&quot;:false,&quot;201341983&quot;:0,&quot;335551550&quot;:1,&quot;335551620&quot;:1,&quot;335559738&quot;:240,&quot;335559739&quot;:240,&quot;335559740&quot;:279}\">\u00a0<\/span><\/li>\n<\/ul>\n<p><span data-contrast=\"none\">These findings highlight the delicate balance between trust and mistrust that can influence the effectiveness of peer-led HIV interventions. To increase the acceptability and success of SNS-based models like eSNS, the study recommends that practitioners address peer credibility, readiness, and the nuanced role of incentives throughout implementation.<\/span><span data-ccp-props=\"{&quot;134233117&quot;:false,&quot;134233118&quot;:false,&quot;201341983&quot;:0,&quot;335551550&quot;:1,&quot;335551620&quot;:1,&quot;335559685&quot;:0,&quot;335559738&quot;:240,&quot;335559739&quot;:240,&quot;335559740&quot;:279}\">\u00a0<\/span><\/p>\n<p><b><span data-contrast=\"none\">Key Contributions:<\/span><\/b><span data-ccp-props=\"{&quot;134233117&quot;:false,&quot;134233118&quot;:false,&quot;201341983&quot;:0,&quot;335551550&quot;:1,&quot;335551620&quot;:1,&quot;335559738&quot;:240,&quot;335559739&quot;:240,&quot;335559740&quot;:279}\">\u00a0<\/span><\/p>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"31\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\uf0b7&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" data-aria-posinset=\"6\" data-aria-level=\"1\"><span data-contrast=\"none\">Provides practical guidance for adapting SNS approaches to the realities of BSGM communities.<\/span><span data-ccp-props=\"{&quot;134233117&quot;:false,&quot;134233118&quot;:false,&quot;201341983&quot;:0,&quot;335551550&quot;:1,&quot;335551620&quot;:1,&quot;335559738&quot;:240,&quot;335559739&quot;:240,&quot;335559740&quot;:279}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"31\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\uf0b7&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" data-aria-posinset=\"7\" data-aria-level=\"1\"><span data-contrast=\"none\">Emphasizes the importance of context, trust, and equity in implementation.<\/span><span data-ccp-props=\"{&quot;134233117&quot;:false,&quot;134233118&quot;:false,&quot;201341983&quot;:0,&quot;335551550&quot;:1,&quot;335551620&quot;:1,&quot;335559738&quot;:240,&quot;335559739&quot;:240,&quot;335559740&quot;:279}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"31\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\uf0b7&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" data-aria-posinset=\"8\" data-aria-level=\"1\"><span data-contrast=\"none\">Informs strategies for integrating social network-based HIV prevention into public health and CBO settings.<\/span><span data-ccp-props=\"{&quot;134233117&quot;:false,&quot;134233118&quot;:false,&quot;201341983&quot;:0,&quot;335551550&quot;:1,&quot;335551620&quot;:1,&quot;335559738&quot;:240,&quot;335559739&quot;:240,&quot;335559740&quot;:279}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"31\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\uf0b7&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" data-aria-posinset=\"9\" data-aria-level=\"1\"><span data-contrast=\"none\">This work reinforces the critical need for tailored, community-informed strategies as we work toward ending the HIV epidemic\u2014especially in high-priority regions like the U.S. South. To read the full article, click <a href=\"https:\/\/implementationsciencecomms.biomedcentral.com\/articles\/10.1186\/s43058-025-00736-7\">here<\/a>.\u00a0<\/span><span data-ccp-props=\"{&quot;134233117&quot;:false,&quot;134233118&quot;:false,&quot;201341983&quot;:0,&quot;335551550&quot;:1,&quot;335551620&quot;:1,&quot;335559738&quot;:240,&quot;335559739&quot;:240,&quot;335559740&quot;:279}\">\u00a0<\/span><\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>A recent qualitative study conducted by Carol Golin, Eunice Okumu, members of the CFAR\u2019s Social, Behavioral, and Implementation Sciences (SBIS) Core, as well as Ann Dennis, the co-leader of the UNC CFAR Scientific Working Group explored key challenges and opportunities in implementing an enhanced Social Network Strategy (eSNS) to expand HIV prevention and care access &hellip; <a href=\"https:\/\/www.med.unc.edu\/cfar\/2025\/06\/understanding-the-peer-paradox-to-improve-hiv-services-for-black-sexual-and-gender-minorities\/\" aria-label=\"Read more about Understanding the \u201cPeer Paradox\u201d to Improve HIV Services for Black Sexual and Gender Minorities\">Read more<\/a><\/p>\n","protected":false},"author":120087,"featured_media":18551,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"layout":"","cellInformation":"","apiCallInformation":"","footnotes":"","_links_to":"","_links_to_target":""},"categories":[1],"tags":[],"class_list":["post-18550","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-news","odd"],"acf":[],"featured_image":"https:\/\/www.med.unc.edu\/cfar\/wp-content\/uploads\/sites\/1380\/2025\/06\/HIV-Views-and-Social-Media-June-20.png","featured_image_medium":"https:\/\/www.med.unc.edu\/cfar\/wp-content\/uploads\/sites\/1380\/2025\/06\/HIV-Views-and-Social-Media-June-20-300x125.png","featured_image_medium_large":"https:\/\/www.med.unc.edu\/cfar\/wp-content\/uploads\/sites\/1380\/2025\/06\/HIV-Views-and-Social-Media-June-20-768x319.png","featured_image_large":"https:\/\/www.med.unc.edu\/cfar\/wp-content\/uploads\/sites\/1380\/2025\/06\/HIV-Views-and-Social-Media-June-20-1024x425.png","featured_image_thumbnail":"https:\/\/www.med.unc.edu\/cfar\/wp-content\/uploads\/sites\/1380\/2025\/06\/HIV-Views-and-Social-Media-June-20-150x150.png","featured_image_alt":"","category_details":[{"name":"News","link":"https:\/\/www.med.unc.edu\/cfar\/category\/news\/"}],"tag_details":[],"_links_to":[],"_links_to_target":[],"_links":{"self":[{"href":"https:\/\/www.med.unc.edu\/cfar\/wp-json\/wp\/v2\/posts\/18550","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.med.unc.edu\/cfar\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.med.unc.edu\/cfar\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.med.unc.edu\/cfar\/wp-json\/wp\/v2\/users\/120087"}],"replies":[{"embeddable":true,"href":"https:\/\/www.med.unc.edu\/cfar\/wp-json\/wp\/v2\/comments?post=18550"}],"version-history":[{"count":1,"href":"https:\/\/www.med.unc.edu\/cfar\/wp-json\/wp\/v2\/posts\/18550\/revisions"}],"predecessor-version":[{"id":18552,"href":"https:\/\/www.med.unc.edu\/cfar\/wp-json\/wp\/v2\/posts\/18550\/revisions\/18552"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.med.unc.edu\/cfar\/wp-json\/wp\/v2\/media\/18551"}],"wp:attachment":[{"href":"https:\/\/www.med.unc.edu\/cfar\/wp-json\/wp\/v2\/media?parent=18550"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.med.unc.edu\/cfar\/wp-json\/wp\/v2\/categories?post=18550"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.med.unc.edu\/cfar\/wp-json\/wp\/v2\/tags?post=18550"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}