the untrained peers in influencing positive health outcomes. Peer education offers the educators the opportunity to benefit from taking on meaningful roles. Peer educators can act as enthusiastic advocates for the program and have a sense of purpose in their community outreach efforts. Peer education is sustainable. This has been found to be an important issue for community-based health promotion interventions to make a difference over time. A grassroots initiative involving volunteers means that the health issue is reaching the target audience continuously with less of a threat of financial cutbacks impacting on their work. Research findings support the use of volunteer peer educators as a feasible and effective healthcare delivery strategy and as having promising indicators of sustainability over time. Sustainability through the engagement of peer educators can strengthen the social environment so that it is supportive of healthy behaviors. Debates Despite its popularity, the evidence about peer education is mixed, and there is no consensus on whether it works or how it works. Researchers have questioned the validity of the assumption that peer education influences behavior. One important line of inquiry suggests that peer education may work in some contexts but not in others. A study comparing peer education among sex workers in India and South Africa found that the more successful Indian group benefited from a supportive social and political context, and a more effective community development ethos, rather than the biomedical focus of the South African intervention. A key issue concerns what a peer is and who defines this. In some instances age is a central factor but in other contexts, commonalities such as status may be more relevant. Caution has been noted regarding selection of peer educators. Some argue that there can be a stigma held against peer educators who have faced adversities in their own lives, particularly by mainstream health service organizations and professionals. Alternatively, peers educators would need to have high status within their social group to be effective. Researchers have argued that peer educators sometimes receive inadequate training, which limits their ability to educate their peers effectively and further state that peer selection and training is very important. An important analysis on the development of many peer education projects is that it is led by adult constructions of adolescence and adolescent health behaviour. A central question should therefore be whose agenda is being served by using peer education projects which manipulate and