Linking peers, patients, and providers: A qualitative study of a peer integration program for hard-to-reach patients living with HIV/AIDS

Hallum-Montes, Rachel; Morgan, Sera; Rovito, Helen M; Wrisby, Cornell; Anastario, Michael

doi:10.1080/09540121.2012.748869

Cited by 26 publications

(31 citation statements)

References 12 publications

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“…This study’s positive results with connection to ACT services aligns with other studies that found improved care engagement as a result of a peer intervention 40 43 44. Qualitatively, this study’s participants expressed views similar to other peer intervention studies regarding the ease of speaking with a peer and the benefit of shared experience 19 45 46. However, this study found that PVs and participants were able to connect despite differences in age, health status and other demographics, which differs from other studies that recommend peers share as many subgroup characteristics as possible 45 47…”

Section: Discussionsupporting

confidence: 72%

The ART of conversation: feasibility and acceptability of a pilot peer intervention to help transition complex HIV-positive people from hospital to community

et al. 2019

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ObjectivesTo pilot a peer-based intervention for people living with HIV who used substances, had challenges with antiretroviral adherence and would be discharged from hospital to community.Study designA community-based, quasi-experimental pilot intervention study designed to assess feasibility, acceptability and connection to a community-based HIV organisation.SettingThis study was conducted in Toronto, Canada, at Casey House (CH; hospital for people living with HIV) in collaboration with the AIDS Committee of Toronto (ACT; community-based HIV organisation).ParticipantsPeople living with HIV who were CH inpatient between 1 April 2017 and 31 March 2018, struggled with antiretroviral adherence, actively used substances and would be discharged to community were eligible. Forty people met criteria, 19 were approached by an inpatient nurse and 17 consented. Average age was 48.8 years (SD=11.4), 58.8% were male and participants averaged 7.8 physical and mental health comorbidities (SD=3.1).InterventionTitled ’The ART of Conversation', the three-pronged personalised intervention was developed through input from CH clients and ACT volunteers, all living with HIV. Intervention components were (a) predischarge goal-setting (adherence, substance use and self-identified goal) with the study nurse; (b) predischarge meeting with an HIV+ peer volunteer (PV) and (c) nine postdischarge phone calls between PV and participant, once per day for 3 days, then once per week for 6 weeks.Primary outcomesFeasibility was measured through proportion of eligible participants recruited and PV availability. Acceptability was assessed through participant interviews at three times (preintervention, post-intervention and 6 weeks follow-up) and through PV call logs. Client records determined connection to ACT within the study timeframe.ResultsTwelve participants completed the intervention and nine connected with ACT. Predischarge goal-setting and PV meeting were both feasible and acceptable. Postdischarge phone calls were a challenge as half of completers missed at least one call.ConclusionsAlthough predischarge goal-setting and PV meeting were feasible, methods to maintain connection following discharge require further investigation.

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Section: Discussionsupporting

confidence: 72%

The ART of conversation: feasibility and acceptability of a pilot peer intervention to help transition complex HIV-positive people from hospital to community

et al. 2019

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“…The first suggests that the emotional and social support provided by the peer may lead to reductions in symptoms of distress caused by an HIV diagnosis and/or to acceptance of the need for long-term healthcare. The connection formed around the shared experience of peers who are living with HIV may have beneficial impacts on health and well-being (23,24). Secondly there may be reductions in internalized stigma, whereby the PLHA witnesses firsthand, through interaction with a designated peer, how HIV is not necessarily a “death sentence,” but can be a chronic, manageable condition when appropriately engaging with care and treatment (25,26).…”

Section: Discussionmentioning

confidence: 99%

Improving Engagement in the HIV Care Cascade: A Systematic Review of Interventions Involving People Living with HIV/AIDS as Peers

et al. 2016

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Improving patient engagement in HIV care is critical for maximizing the impact of antiretroviral therapy (ART). We conducted a systematic review of studies that used HIV-positive peers to bolster linkage, retention, and/or adherence to ART. We searched articles published and indexed in Pubmed, PsycINFO, and CINAHL between 1996–2014. Peers were required to be HIV-positive. Studies were restricted to those published in English. Nine studies with n=4,658 participants met the inclusion criteria. Peer-based interventions were predominantly focused on improving adherence to ART, or evaluations of retention and adherence via viral suppression. Five (56%) were conducted in sub-Saharan Africa. Overall findings were mixed on the impact of peers on ART adherence, viral suppression, and mortality. While positive effects of peer interventions on improving linkage and retention were found, there were limited studies assessing these outcomes. Additional research is warranted to demonstrate the impact of peers on linkage and retention in diverse populations.

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“…Taking a closer look at the subset of newly diagnosed individuals is of particular interest, as this group may serve as a bridge to category “individuals not tested,” commonly described as “hard-to-reach” populations [ 34 , 69 – 75 ]. Remarkably, more than 30% of individuals tested for HIV during the enhanced HBHTC were tested for the first time, suggesting that HBHTC could be an efficient tool for reaching individuals who have never been tested previously in southern African communities.…”

Section: Discussionmentioning

confidence: 99%

Estimated age and gender profile of individuals missed by a home‐based HIV testing and counselling campaign in a Botswana community

Novitsky

Bussmann

Okui

et al. 2015

Journal of the International AIDS Society

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IntroductionIt would be useful to understand which populations are not reached by home-based HIV-1 testing and counselling (HTC) to improve strategies aimed at linking these individuals to care and reducing rates of onward HIV transmission.MethodsWe present the results of a baseline home-based HTC (HBHTC) campaign aimed at counselling and testing residents aged 16 to 64 for HIV in the north-eastern sector of Mochudi, a community in Botswana with about 44,000 inhabitants. Collected data were compared with population references for Botswana, the United Nations (UN) estimates based on the National Census data and the Botswana AIDS Impact Survey IV (BAIS-IV). Analyzed data and references were stratified by age and gender.ResultsA total of 6238 age-eligible residents were tested for HIV-1; 1247 (20.0%; 95% CI 19.0 to 21.0%) were found to be HIV positive (23.7% of women vs. 13.4% of men). HIV-1 prevalence peaked at 44% in 35- to 39-year-old women and 32% in 40- to 44-year-old men. A lower HIV prevalence rate, 10.9% (95% CI 9.5 to 12.5%), was found among individuals tested for the first time. A significant gender gap was evident in all analyzed subsets. The existing HIV transmission network was analyzed by combining phylogenetic mapping and household structure. Between 62.4 and 71.8% of all HIV-positive individuals had detectable virus. When compared with the UN and BAIS-IV estimates, the proportion of men missed by the testing campaign (48.5%; 95% CI 47.0 to 50.0%) was significantly higher than the proportion of missed women (14.2%; 95% CI 13.2 to 15.3%; p<0.0001). The estimated proportion of missed men peaked at about 60% in the age group 30 to 39 years old. The proportions of missed women were substantially smaller, at approximately 28% within the age groups 30 to 34 and 45 to 49 years old.ConclusionsThe HBHTC campaign seems to be an efficient tool for reaching individuals who have never been tested previously in southern African communities. However, about half of men from 16 to 64 years old were not reached by the HBHTC, including about 60% of men between 30 and 40 years old. Alternative HTC strategies should be developed to bring these men to care, which will contribute to reduction of HIV incidence in communities.

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Linking peers, patients, and providers: A qualitative study of a peer integration program for hard-to-reach patients living with HIV/AIDS

Cited by 26 publications

References 12 publications

The ART of conversation: feasibility and acceptability of a pilot peer intervention to help transition complex HIV-positive people from hospital to community

The ART of conversation: feasibility and acceptability of a pilot peer intervention to help transition complex HIV-positive people from hospital to community

Improving Engagement in the HIV Care Cascade: A Systematic Review of Interventions Involving People Living with HIV/AIDS as Peers

Estimated age and gender profile of individuals missed by a home‐based HIV testing and counselling campaign in a Botswana community

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