Peer HIV/AIDS education with volunteer trishaw drivers in Yaan, People's Republic of China: process evaluation.

Peer-based HIV prevention education has become increasingly popular in China. Few studies have explored culturally appropriate strategies or the effectiveness of this approach among the growing population of Chinese self-employed young people--a group quite vulnerable to HIV and other sexually transmissible infections. The findings presented here are from a process evaluation of a peer-led demonstration project with self-employed trishaw drivers in Yaan, China. This study examines sexual health message diffusion from 150 volunteers in a direct training group to 705 peers in an indirect training group. A key finding was that success in diffusing sexual health messages was significantly related to drivers' attachment to their subculture. The successful elements of the project augur well for the development of HIV peer education in the broader arena of self-employed young people in China and pose a challenge to the traditional approach of "official-led" peer education with its uniform prescription of officially sanctioned printed materials.