A Scoping Review of the Empirical Literature on Peer Support for People Living with HIV

Øgård-Repål, Anita; Berg, Rigmor C.; Fossum, Mariann

doi:10.1177/23259582211066401

Cited by 9 publications

(9 citation statements)

References 63 publications

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“…Although the effectiveness of a range of peer support interventions has been studied, a recent review [ 33 ] demonstrated a scarcity of studies that explored experiences with peer support from the receiver’s perspective. The results of the review indicated multiple benefits of meeting a peer supporter, necessitating a clarification of the peer support provided to PLHIV as a CLLC.…”

Section: Introductionmentioning

confidence: 99%

Peer support in an outpatient clinic for people living with human immunodeficiency virus: a qualitative study of service users’ experiences

Øgård-Repål

Berg

Skogen

et al. 2022

BMC Health Serv Res

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Background Although human immunodeficiency virus (HIV) has become a manageable condition with increasing life expectancy, people living with HIV (PLHIV) are still often isolated from society due to stigma and discrimination. Peer support provides one avenue for increased social support. Given the limited research on peer support from the perspective of PLHIV, this study explored their experiences of peer support organised by healthcare professionals in an outpatient clinical setting. Methods The study used a qualitative, descriptive research design for an in-depth understanding of peer support provided to PLHIV in the context of outpatient clinics. Healthcare professionals contributed to the recruitment of 16 participants. We conducted in-depth interviews about participants’ experiences of peer support, and performed a directed content analysis of the data. Further, we sorted the data into pre-determined categories. Results The pre-determined categories constituted attachment, social integration, an opportunity for nurturance, reassurance of worth, reliable alliance, and guidance. The identified themes were: gained emotional support, disclosure behaviour allowed garnering of emotional support, non-disclosure promoted the need to meet a peer, experienced a sense of belonging, activated an opportunity for mutual support, means to re-establish belief in one’s own worth, perceived a positive affirmation of disease management, facilitated dialogue about disease management, the outpatient clinic as a safe place, and a setting for flexible, individualised support. Conclusions This study highlights the peer support experiences of PLHIV in the context of outpatient clinics. The participants’ experiences align with previous findings, showing that peer support contributes to mutual emotional support between peers. This is particularly important in cultures of non-disclosure where PLHIV experience intersectional stigma. Additionally, our results show outpatient clinics to be supportive surroundings for facilitating peer support, ensuring confidentiality in peer support outreach. Therefore, peer support contributes positively to individualising outpatient clinic services to meet the changing needs of PLHIV.

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Section: Introductionmentioning

confidence: 99%

Peer support in an outpatient clinic for people living with human immunodeficiency virus: a qualitative study of service users’ experiences

Øgård-Repål

Berg

Skogen

et al. 2022

BMC Health Serv Res

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“…Using this score to predict likelihood of unsuppressed viral load at the beginning of treatment and tailoring scheduled clinic visits to predicted viral load suppression will reduce the cost of treatment for people on care for the first 18 months. Currently, Kenya employs several evidence based interventions in supporting adherence including community based support groups and individual level support through peer champions or peer navigators [ 14 ]. Use of this empiric scoring tool will alleviate the burden on patients and reduce the strain on the public health system by allowing clinicians to reduce the time spent with patients predicted to have suppressed viral load while focusing intensified adherence support to those predicted to be virally unsuppressed.…”

Section: Discussionmentioning

confidence: 99%

An empiric tool to identify Kenyans living with HIV who will have unsuppressed viremia 18 months following treatment initiation to guide differentiated care models

et al. 2022

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Background With the global push towards universal access to Antiretroviral Treatment (ART), patient numbers are increasing, further straining already under-resourced healthcare systems in sub-Saharan Africa. A simple scoring tool could be useful in optimizing differentiated service delivery by identifying individuals likely to have unsuppressed viral load. Methods Using existing data of patients accessing ART at public health facilities that were extracted from the Kenya Electronic Medical Record (KenyaEMR) and standard methods of developing a clinical prediction tool; we created and validated a risk scoring tool to identify persons likely to be virally unsuppressed at 18 months post-ART initiation. Data from the KenyaEMR were cleaned, merged and reviewed for completeness. We utilized multivariate modelling to determine key predictors of viral load suppression that could be measured in clinical settings. Results We assessed clinical reports of 3,968 patients on ART who had been on ART for at least 18 months and had at least one viral load result and were ≥ 18 years old. Of these, the majority (81%) were virally suppressed 18 months post-ART initiation. The final risk score included age, sex, body mass index at HIV diagnosis, number of years of formal education, disclosure status, and duration of time between HIV diagnosis and initiating ART. The maximum risk score was 78; a risk score of ≥22 was associated with unsuppressed viral load (>1000copies/mL). The area under the curve (AUC) for the probability of the risk score to correctly predict unsuppressed viral load was 0.55 (95% CI: 0.52 to 0.56). Internal and external validation showed similar predictive ability. Conclusions Routinely collected variables in a public HIV clinic medical record predicts, with modest accuracy, individuals likely to have unsuppressed HIV viremia 18 months after they initiate ART. The use and application of this tool could improve and complement efficiency in differentiated care models for patients on ART.

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“…Future research likely involves testing an intervention that includes telemedicine and/or peer support as strategies to facilitate HIV care engagement examining dual outcomes of treatment initiation and care retention among rural PWH. Based on a recent scoping review of peer support for PWH, research on the topic has increased in the last decade and yet gaps in evidence warrant continued study 33 …”

Section: Discussionmentioning

confidence: 99%

Barriers and facilitators to HIV care engagement: Recommendations from people with HIV in rural Arkansas

Marshall

Tao

Horton

et al. 2022

The Journal of Rural Health

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Purpose: Little is known about factors affecting HIV care engagement and retention among rural people with HIV (PWH) in the South. About half of PWH in Arkansas reside in rural areas. The purpose of this study was to explore factors affecting engagement and retention in HIV care among PWH in rural areas of Arkansas. Methods: We conducted an exploratory qualitative study in 2020 and completed individual interviews (N = 11) with PWH in rural counties in Arkansas. Findings: Content analysis revealed the following themes: (1) Barriers to HIV care included long distances to the nearest HIV clinic and transportation issues along with anticipating and/or experiencing HIV-related stigma; (2) facilitators of HIV care included having a helpful HIV care provider and Ryan White case manager and a social support network that aided them in prioritizing their own health; (3) participants had the most favorable reactions to Ryan White case management, peer navigators, and telemedicine for HIV treatment/care; and (4) participants demonstrated resilience overcoming various obstacles as they worked toward being healthy mentally and physically while living with HIV. Conclusion: Interventions need to address multilevel factors, including hiring PWH as peer navigators and/or caseworkers and offering HIV care via telemedicine, to improve HIV care engagement and retention among rural populations.

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A Scoping Review of the Empirical Literature on Peer Support for People Living with HIV

Cited by 9 publications

References 63 publications

Peer support in an outpatient clinic for people living with human immunodeficiency virus: a qualitative study of service users’ experiences

Peer support in an outpatient clinic for people living with human immunodeficiency virus: a qualitative study of service users’ experiences

An empiric tool to identify Kenyans living with HIV who will have unsuppressed viremia 18 months following treatment initiation to guide differentiated care models

Barriers and facilitators to HIV care engagement: Recommendations from people with HIV in rural Arkansas

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