The effectiveness and sustainability of peer support interventions for persons living with HIV: a realist synthesis

Abstract

BackgroundPeer support is an important supplement to medical resources for persons living with HIV (PLHIV). However, previous studies have shown mixed results about intervention effects. It is necessary to explain the mechanism of peer support interventions’ effectiveness and sustainability to help design more valid peer support interventions.ObjectiveTo identify and explain the mechanisms that drive the effectiveness and maintain the sustainability of peer support interventions.MethodsA preliminary theoretical framework was developed through a scoping review of the grey literature and international project frameworks in five professional websites. We then refined the framework by systematically searching evidence in databases including PubMed, EMBASE, Web of Science, ProQuest, CINAHL, CNKI and Wanfang. Qualitative methods were used to generate codes and themes relating to the studies’ context, mechanisms and outcomes. We checked chains of inference (connections) across extracted data and themes through an iterative process.ResultsA total of 6345 articles were identified, and 52 articles were retained for final synthesis. The refined theoretical framework presents five areas of peer support, including informational support, instrumental support, emotional support, affiliational support and appraisal support; five types of outcomes that peer support can improve for PLHIV, including physiological outcomes, psychological outcomes, behavioural outcomes, cognitive outcomes and social outcomes; the effectiveness mechanism coding system from peer volunteers and the relationship between peer volunteers and PLHIV; and the sustainability mechanism coding system in terms of peer volunteers, PLHIV and study context.ConclusionsGiven that peer support has huge potential human resources, that is, all the qualified PLHIV, irreplaceable advantages in dealing with barriers to HIV-related discrimination and potential comprehensive benefits for PLHIV, it is necessary to develop and organise more peer support projects for PLHIV. Our study highlights that the expansion of peer support projects should be based on their effectiveness and sustainability.PROSPERO registration numberCRD42022339079.

Examining the Role of Third Sector Organization Volunteers in Facilitating Hospital-to-Home Transitions for Older Adults – a Collective Case Study

“…Volunteers in our study also provided peer support grounded in their own lived experiences. The benefits of peer-client relationships based upon shared experiences have been found to validate the recipient [32] and instrumental and information support [83].…”

Defining HIV-Related Social Support: What Types of Social Support Do People With HIV Need?

“…Other authors frequently cited social support dimensions as informational, instrumental, emotional, and appraisal support (Barrera, 1986; House, 1981; Tilden & Weinert, 1987). From our previous realist synthesis (Han et al, 2023), we believe these previous conceptions could substantively capture the needs of PWH. Given that HIV is lifelong and continues to involve experiences with HIV-related stigmas, we would like to introduce affiliational support as a new dimension of social support.…”

Intervensi Berbasis Kelompok Sebaya (Peer Group Suport) dalam Upaya Peningkatan Kepatuhan Pengobatan ARV pada ODHA

“…Mengingat bahwa dukungan teman sebaya sangat besar potensi sumber daya manusia, yaitu semua yang berkualitas ODHA, keuntungan yang tak tergantikan dalam menangani hambatan terhadap potensi dan diskriminasi terkait HIV manfaat yang komprehensif bagi ODHA, maka perlu dilakukan mengembangkan dan mengatur lebih banyak proyek dukungan sebaya untuk ODHA (Han et al, 2023).…”