Peers in HIV care are specially-trained individuals who serve on the health care team to provide patients with information, support, and assistance in navigating services. HIV peers are often living with HIV, but not always. Their qualifications and roles rest on their connection with the community they serve. Peer programs serve to recruit, train, and support peers so that they can carry out their duties.
Best Practices
- Center for Innovation and EngagementCollection of implementation guides on evidence-informed best practices in HIV care delivery.
- Boston University School of Social Work Center for Innovation in Social Work and HealthResources to help clinics integrate community health workers (CHW) into an HIV multidisciplinary team model.
- AIDS Action Foundation
Workbooks describing ways to help connect people living with HIV/AIDS to medical care. Estos cuadernos describen la manera de asistir a conectar personas que viven con VIH/SIDA con el sistema médico.
- IHIPComponents of an intervention focused on BMSM with HIV who have not yet been successfully maintained in care.
- IHIPProject to enhance the provision of HIV care for Latina transgender women in Los Angeles County.
- IHIPMobile app for youth offering information, social networking, and self-management tools to support holistic HIV care.
- SPNS Latino Access Initiative, UCSF Center for AIDS Prevention Studies
Monographs describing interventions for the engagement and retention of Latinos in HIV care.
- Boston University School of Social Work Center for Innovation in Social Work and Health, The HIV, Housing & Employment Project
Best practices (and extensive resource links) for integrating into medical care teams the non-medical staff called Navigators.
- SPNS Systems Linkages Project
Insights from a multi-state demonstration and evaluation of innovative models for linkages to and retention in HIV care.
- Boston University School of Social Work Center for Innovation in Social Work and Health
SPNS innovative and replicable HIV service delivery models using HIV+ peers.
- IHIP
Implementation guide for HIV providers on addressing the unique needs of women of color living with HIV.
- HRSA HIV/AIDS Bureau (HAB)
Compilation of SPNS grantee experiences with peer models and how they can be used in various care settings.
- Next Step and Mass CARE
Guidebook for multiple audiences that outlines steps for transitioning youth from pediatric care to adult services.
- HRSA HIV/AIDS Bureau (HAB)
This is an Evaluation Report of a pilot peer navigation program funded by HRSA/HAB. It is a part of the Minority AIDS Initiative. It trained patient navigators at harm reduction sites in New Jersey and New Mexico.
- HRSA HIV/AIDS Bureau (HAB)
Pilot-test of an online meeting Using Web 2.0 tools vs. a traditional in-person meeting venue with women infected or affected by HIV infection.
- HRSA HIV/AIDS Bureau (HAB)
Case studies examining the effectiveness of models of peer support for Caribbean immigrants living with HIV in the U.S.
- Best Practices CompilationHispanic and Latino clients served by the team received culturally responsive care and linkages to external community resources, with resulting greater retention in care and improved viral suppression rates.
- Best Practices CompilationThe Bottom-Up Project is a multi-organizational initiative focused on leveraging health information exchange data and peer navigation. Using real-time clinical data, in combination with linkage to HIV care and social services, the Bottom-Up Project locates and reengages people with HIV who are not currently in medical care and are not virally suppressed. Through this collaboration, over half of patients on the lost-to-follow-up list were found and invited to enroll in the linkage to care/reengagement program.
- Best Practices Compilation2BU is a case management intervention designed to engage and reengage Black men who have sex with men with HIV into HIV care services. Peer case managers work closely with clients to increase HIV health literacy, troubleshoot accessibility issues to HIV care, and connect clients directly to behavioral health and support services. Clients who participated in 2BU had increased retention in care and viral suppression 12 months after enrollment.
- Best Practices CompilationThis medical-community partnership worked to link clients to care and decrease missed appointments and used peer navigators to successfully re-engage clients in care.
- Best Practices CompilationTen organizations across the U.S. integrated Community Health Workers (CHWs) into their multidisciplinary care teams. Enrolled clients had statistically significant improvements in viral suppression, antiretroviral therapy prescription, and appointment attendance after six months in the program.
- Best Practices CompilationLehigh Valley Health Network Comprehensive Health Services implemented a trauma-informed approach to care delivery, including training staff on how trauma can affect people’s health and how microaggressions in healthcare environments can potentially trigger trauma responses. This approach positively impacted care delivery and the program’s retention in care rate.
- Dissemination of Evidence Informed-Interventions Project (DEII)Patient navigation intervention informed and adapted from the best practice findings of a past SPNS initiative that yielded successful HIV care continuum outcomes among client participants.
- Best Practices CompilationERASE was developed to address the unique needs of Black MSM. Through an intensive case management intervention, peer case managers provide health education and wellness support, and connect clients to medical and behavioral healthcare. ERASE also offers a physical “safe space” for Black MSM to meet with a case manager, access medical services, or connect with peers. Enrollment in ERASE improved retention in HIV care for clients.
- Best Practices CompilationHealthy Divas focuses on empowering transgender women with HIV to achieve their personal health goals. Three sites implemented the intervention as part of the E2i initiative funded through the RWHAP Part F SPNS program from 2017 through 2021. Both engagement in HIV care and having an antiretroviral therapy prescription improved significantly for clients 12 months after enrollment in Healthy Divas.
- Best Practices CompilationThis referral-based oral health model used dental navigators to connect clients to a large network of dentists, which facilitated scheduling of appointments.
- Best Practices CompilationLINK LA is a 12-session, 24-week peer navigation intervention for people with HIV who are scheduled to be released from incarceration. LINK LA peer navigators focus on behavioral changes that promote medication adherence and retention in care, while providing social support and facilitating communication with medical providers. LINK LA showed improvements in linkage to and retention in HIV care and viral suppression among people with HIV re-entering the community after incarceration.
- Best Practices CompilationThe Navigator Case Management intervention helps people with HIV who are incarcerated and are leaving to return to the community. The intervention uses harm reduction, case management, and motivational interviewing techniques to promote healthy behaviors. Enhanced case management including peer support and connection to other needed services both immediately before and after release supports increased linkage to and retention in HIV care for people transitioning to the community from jail.
- Best Practices CompilationUniversity Health uses peers and patient navigators to provide support, reduce barriers, and improve linkage and retention to care for women and youth with HIV. Two peers with lived experience were hired as Outreach Specialists to spearhead the program, encourage medication adherence and use of services, and provide mentoring. The intervention was successful in moderately improving the numbers of clients linked to care, retained in care, and virally suppressed.
- Best Practices CompilationFrom 2016 through 2019, three clinics—AIDS Care Group, Howard Brown Health, and Meharry Medical College—participated in a RWHAP Part F SPNS DEII initiative to implement peer linkage and re-engagement interventions for women of color with HIV. Integrating peers into HIV primary care teams has been effective in better engaging women of color in care.
- Dissemination of Evidence Informed-Interventions Project (DEII)Peer linkage and re-engagement intervention, informed and adapted from the best practice findings of a past SPNS initiative.
- Best Practices CompilationThe Positive Peers app motivates youth and young adults with HIV to stay engaged in HIV care through self-management tools and virtual support. Although specific outcomes vary by age group, individuals who used the app were more likely to attend their medical appointments, receive labs, and reach viral suppression.
- Best Practices CompilationProject ACCEPT is designed to improve engagement and retention in medical care for youth ages 16 to 24 years with newly diagnosed HIV. The educational and skill-building intervention was deployed at four demonstration sites and increased rates of medication use and appointment adherence in comparison to a control group. Although originally developed for cisgender youth, Project ACCEPT may be adapted for gender-diverse people.
- Best Practices CompilationProject CONNECT uses linkage coordinators to effectively engage people in HIV medical care. It focuses on people with newly diagnosed HIV or people with HIV who are transferring their care or have been out of care. AIDS Taskforce of Greater Cleveland implemented Project CONNECT as part of E2i, an initiative funded by the RWHAP Part F SPNS program from 2017–2021. Project CONNECT was successful in increasing the number of clients retained in HIV care and who reached viral suppression.
- Best Practices CompilationSTYLE 2.0 is a multi-component intervention designed to help reduce stigma and social isolation for Black gay, bisexual, and other men who have sex with men. The intervention relies on health care navigators who facilitate linkage and engagement activities. They also connect clients to behavioral health providers who conduct motivational interviewing, as well as to a mobile application that supports all intervention activities. STYLE 2.0 participation has been associated with positive trends across HIV care continuum outcomes, including retention in care and increased viral suppression.
- Best Practices CompilationProject Vogue provided community-based care coordination, HIV care, and behavioral health services to Black men who have sex with men (MSM) within New York City’s House & Ball community to address the unique cultural barriers that Black MSM experience when trying to access care. Project Vogue participants were linked to behavioral health services as well as to non-clinical supportive services, such as food and housing assistance.
- Best Practices CompilationThe Ruth M. Rothstein CORE Center launched Proyecto Promover to decrease HIV testing-related stigma, increase awareness of HIV status, and increase early linkage to and retention in care among Mexicanos with HIV. The program operates at the community level through social marketing, educational talks, networking, and testing. On the individual level, Proyecto Promover uses one-on-one conversations to identify and overcome barriers related to care engagement and retention. Evaluation showed promising rates of HIV testing, retention in care, and viral suppression.
- Best Practices CompilationThe Alexis Project used social network recruiting and engagement, peer navigation, and contingency management to reach and engage transgender women of color with HIV who were not engaged in HIV care. Participation in the 18-month intervention improved linkage to care and viral suppression.
- Best Practices CompilationThe Village Project is an intensive case management-based intervention that harnesses peer navigation and integrated behavioral health services to improve the health outcomes of young Black gay, bisexual, and men who have sex with men. The Village Project was associated with increased retention in care and viral suppression.
- Best Practices CompilationBienestar developed TransActivate to improve timely engagement and retention in HIV care among Latina transgender women. Linkage coordinators/peer navigators use a strengths-based approach to help clients reach their goals of entering and staying in medical care to ultimately reach viral suppression.
- Best Practices CompilationThe Rutgers New Jersey Medical School created a transgender health program and integrated it into their Infectious Disease Practice. The program conducted community outreach to engage transgender men and women in care, trained all staff on gender affirming care, hired transgender staff, provided gender affirming care and hormone treatments onsite, and offered mental health support to patients.
- Best Practices CompilationT.W.E.E.T. aims to engage transgender women in HIV care by combining weekly peer-based education and discussion groups, leadership training, community building, and the provision of supportive services. Three sites implemented T.W.E.E.T. as part of E2i, an initiative funded by the RWHAP Part F SPNS program from 2017–2021. Clients had improved outcomes across the HIV care continuum 12 months after enrollment in T.W.E.E.T.
- Best Practices CompilationViviendo Valiente aims to reduce ethnic disparities in HIV care and outcomes by providing culturally responsive services to the Latino/a community, specifically to people of Mexican descent. It is a multi-level intervention, featuring individual-, group-, and community-level activities, that links people to HIV care, offers HIV education and health literacy in group sessions, and promotes community-level testing for HIV and other sexually transmitted infections (STIs). Viviendo Valiente had positive impacts on HIV testing, retention in care, viral suppression, and client satisfaction.
- Best Practices CompilationThe YGetIt? Program engaged youth and young adults with HIV in care through three components: a health management mobile application (GET!), Peer Engagement Educator Professionals (PEEPs), and a graphic serial (Tested). Tested received over 200,000 views, and viral suppression rates among YGetIt? participants increased from 79% to 86% over the course of the program.
Resources
- HRSA HIV/AIDS Bureau (HAB)
Toolkit for implementing a program to support HIV-positive youth transitioning from adolescent to adult HIV care.
- Boston University School of Social Work Center for Innovation in Social Work and Health, HRSA HIV/AIDS Bureau (HAB)
Training compendium for agencies seeking to develop programs that utilize peers to help engage and retain other people with HIV in care. Also en Espanol: Componentes Esenciales para la Capacitación y Éxito de los Trabajadores Pares (Peers)
- HRSA HIV/AIDS Bureau (HAB)
Tools on including peer advocates as part of multidisciplinary teams to engage people with HIV in care.
- HRSA HIV/AIDS Bureau (HAB)
Materials to help programs develop strategies to employ Ryan White consumers/people with HIV.
- HRSA HIV/AIDS Bureau (HAB)
Methods that involve persons with HIV to help link others into care.
- Dissemination of Evidence Informed-Interventions Project (DEII)Series of six brief, animated videos with HIV-specific patient education tailored for women of color with HIV.
- Dissemination of Evidence Informed-Interventions Project (DEII)Esta es una serie de seis videos animados breves que brinda educación específica sobre el VIH para pacientes y está destinada especialmente a mujeres de color que viven con el VIH.
- Abt Associates
Curriculum of educational sessions to promote client engagement and retention in HIV care, based on evidence informed practices, including motivational interviewing.
- IHIP
Insights on ways that HIV care programs have improved health outcomes along the HIV care continuum.
- HRSA HIV/AIDS Bureau (HAB)
Review of program costs and outcomes for the Ryan White SPNS Caribbean Peer Promoter Initiative.
- HRSA HIV/AIDS Bureau (HAB)
Review of the costs and correlates of turnover among peer/outreach workers employed under Ryan White SPNS projects.
Training Modules
- IHIP
Tools to help health care providers adapt SPNS models within their existing operations in order to better engage hard-to-reach people with HIV into care.