Implementing Peer-Based HIV Interventions in Linkage and Retention Programs: Successes and Challenges

A Scoping Review of Peer Navigation Programs for People Living with HIV: Form, Function and Effects

“…Of the studies with qualitative components, four papers developed program theory and provided descriptions of the processes and mechanisms that led to effects on HIV care continuum outcomes (see Table 5 ). Studies also explored the needs of target populations in relation to healthcare engagement and the HIV continuum of care [ 29 , 31 , 46 ] or described enablers and barriers for successful implementation [ 42 , 47 , 52 ]. The feasibility [ 34 , 49 ], acceptability [ 29 , 34 , 46 , 49 , 53 ] and safety [ 34 ] of programs targeting these outcomes were also assessed, with positive results.…”

“…Most studies in our review reported information about the training, support, supervision, pay and conditions available for peer navigation roles but were less frequently set up to evaluate the quality or influence of these factors on the effectiveness of programs. A common finding among studies which did consider the influence of pay and conditions was that workplaces and employment structures which provided the most stability and flexibility for navigators to meet their own health and wellbeing needs contributed to the successful delivery of programs [ 32 , 43 , 47 , 52 , 68 ]. There was also evidence that more intensive and structured supervision for peer navigators providing a range of support led to better program outcomes [ 47 , 50 ].…”

“…A common finding among studies which did consider the influence of pay and conditions was that workplaces and employment structures which provided the most stability and flexibility for navigators to meet their own health and wellbeing needs contributed to the successful delivery of programs [ 32 , 43 , 47 , 52 , 68 ]. There was also evidence that more intensive and structured supervision for peer navigators providing a range of support led to better program outcomes [ 47 , 50 ].…”

“…The majority of programs investigated by studies in our review were managed or delivered in clinical healthcare settings. Challenges noted in these environments included power imbalances and a lack of organisational safety and employment frameworks for navigators to be openly recruited, identify and operate in their capacity as peers [ 47 , 52 ]. Policy development and training for clinical providers to better understand the values and practices underpinning peer work was recommended by these studies as well as practice-based guidelines and standards, which further emphasise the promotion of GIPA/MIPA principals [ 11 – 16 ].…”

Trends in U.S. HIV Peer Health Worker Training Strategies and Approaches: A Scoping Review of the Literature

“…For example, some peers rated their training highly, feeling prepared to deliver the intervention (Cully et al, 2012), whereas others felt overwhelmed by their training and reported that motivational interviewing was, in particular, difficult to incorporate (Ryerson Espino et al, 2015). For some, they felt it would take 2–3 years to feel prepared in their role of a peer (Ryerson Espino et al, 2015). Training needs described by peers included more training with role-play (formal and/or informal) and a focus on behavioral change science (Cully et al, 2012; Enriquez et al, 2013).…”