There is a long tradition of using peer-based interventions in sexual health promotion, particularly in relation to HIV/AIDS prevention ( Janz et al, 1996; Medley et al, 2009). This chapter presents findings from a case study of a sexual health outreach project that worked within the gay community to promote uptake of sexual health screening services. Volunteers were involved in supporting a community-based screening service for men who have sex with men and undertook peer education in gay bars and clubs. This small sexual health outreach project is of interest not only because it illustrates lay involvement within a community of identity rather than place, but also because it highlights some interesting issues about boundaries, roles and relationships within a community where health inequalities arise from stigmatisation and marginalisation of health needs (Daley, 2006). The chapter evidences some good practice in relation to support, training and development throughout the volunteer journey. The chapter starts by giving a brief overview of peer education approaches to promote sexual health within lesbian, gay, bisexual and transsexual (LGBT) communities.

Peer education in sexual health

Peer education methods and related approaches are used as the basis for sexual health promotion interventions, predominantly around prevention of sexually transmitted infections (STIs). It is argued that peers, sharing a common identity with the ‘target community’, will be able to communicate directly by using a common language and individuals will be more receptive to health messages from people who are perceived to share social norms, attitudes and experiences (Hart, 1998; Parkin and McKeganey, 2000). For public health, a further justification is the ability of peers to reach communities that are marginalised or underserved (McQuiston and Uribe, 2001). There is some evidence of effectiveness in relation to increased knowledge of HIV (Medley et al, 2009), condom use (Grinstead et al, 1999) and uptake of sexual health services (Williamson et al, 2001). Peer educators may be able to overcome barriers related to the sensitive or even taboo nature of some sexual behaviours, for example, distributing information in ‘public sex environments’ (French et al, 2000). However, in a peer-based intervention for male escorts, the issue of confidentiality was found to be a concern for men, some of whom suggested that due to embarrassment, ‘outsiders’ might, in fact, be a more appropriate source of information (Ziersch et al, 2000).