Peer navigators' role in supporting people living with human immunodeficiency virus in Australia: Qualitative exploration of general practitioners' perspectives

Abstract

The redefining of human immunodeficiency virus (HIV) from an acute disease to a manageable chronic illness has reshaped the focus of care, emphasising clinical outcomes and sidelining the complex social barriers many people living with HIV (PLHIV) still face. This parallels changes in the location of HIV care in Australia, with many PLHIV seeking care from private general practitioners whose ability to address complex social issues is constrained by limitations of time and resources. In response, peer navigation has emerged as a model of care implemented by some HIV‐based community health organisations seeking to support PLHIV’s biomedical and psychosocial needs. However, there is limited understanding of how peer navigation operates in community settings or of the way these programmes integrate with primary care. This paper is the first to explore peer navigation from the perspective of general practitioners (GPs), with experience in treating PLHIV, to understand the role they see for peer navigators (PNs) in supporting PLHIV. Semi‐structured in‐depth interviews were conducted with six GPs (11.5% of specialty HIV GPs in Queensland, Australia) to examine their views and experiences of peer navigation in the context of HIV care. GPs highlighted the complexities of care for PLHIV and the need for additional resources and supports for psychosocial care. GPs valued peer navigation as part of a patient support network and bridge to health and social care systems. PNs normalised HIV, alleviating fear and stigma, educating and translating clinical information for patients. However, a key challenge was the absence of direct communication pathways with PNs. Peer navigation has clear potential in supporting the care of PLHIV, to alleviate constraints in GP settings and expand HIV care beyond the clinic.

Belonging, social connection and non‐clinical care: Experiences of HIV peer support among recently diagnosed people living with HIV in Australia

“…Our findings reflect previous research that demonstrates peerbased programs can support PLHIV in navigating the clinical, social and emotional aspects of living with HIV (Cabral et al, 2018;Khalpey et al, 2021;Koester et al, 2014;Peterson et al, 2012) While peer support is recognised by HIV clinicians as an important part of HIV care (Khalpey et al, 2021), referral pathways to these services are often unstructured and informal (Murphy et al, 2017).…”

Finding a safe space for learning and exploration: A qualitative study of recently diagnosed men’s experiences of peer support for HIV in Sweden

“…Those who acquired HIV in their late teens and early twenties experienced peer support organizations consisting of primarily older men and desired spaces and activities specifically for youth. The importance of providing tailored peer support has been observed in other studies [ 7 , 34 – 37 ]. Within a Swedish context however, our finding regarding the unmet peer support needs of youth is novel and warrants further investigation.…”

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

“…More awareness and communication between peer volunteers and medical professionals are necessary to help peer volunteers better integrate into the medical context. 52 83 The process of communication also provides good opportunities for project feedback and communication. The medical context also needs to provide continuous training for peer volunteers, which meets PLHIV’s need for knowledge updates and self-management; it also helps peer volunteers better service PLHIV and promote the sustainability of peer support projects.…”