<i class="fa fa-group"> </i> Peers

Peer Linkage and Re-Engagement of HIV-Positive Women of Color

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This intervention has been informed and adapted from the best practice findings of a past SPNS initiative. It is currently being implemented and evaluated across each of the 4 interventions developed, at a total of 12 funded sites. Based on the findings of this current implementation, a final evidence-informed toolkit will be designed and available at the end of 2021. Contact information provided is required in order to download these materials for review and/or implementation; however, all information is protected and any follow-up will be limited to collecting information on your impressions and experiences related to the materials and any implementation you may have done of the interventions covered therein.

Intervention Summary

Continuum of Care reengagement

The Peer Linkage and Re-Engagement of HIV-Positive Women of Color intervention is designed to best serve Women of Color (WoC) who are newly diagnosed with HIV or who have fallen out of HIV primary care. Trained HIV-positive WoC known as "peers" will link and re-engage patients in HIV primary care. Patients will be considered linked or re-engaged once they have attended 2 medical appointments, attended 1 case management appointment, and have completed HIV lab work (all within a 4 month period). Peers offer a unique personal perspective and can provide coaching and emotional support to patients who may need assistance in managing medical and case management appointments. In addition, peers who work closely with case managers and the clinical team can better provide individualized patient-centered services over a short time period to address immediate patient needs and build trust between the patient and the clinic team.

This intervention is intended for organizations, agencies, and clinics considering a short-term, peer-focused model to increase linkage and re-engagement of HIV-positive Women of Color into HIV primary care to ultimately improve patient health outcomes.

Professional Literature

The involvement of peers has played a role in the Ryan White HIV/AIDS Program since its inception in 1990.1 According to a HRSA consultation meeting assessing the use of peers in HIV care, "An array of peer education models have proven effective in helping people living with HIV/AIDS overcome barriers to accessing HIV care, and enabling them to build the skills, knowledge and self-confidence necessary to facilitate their retention in care. Everyone—patient, clinician, funder—benefits from the improved health outcomes and greater access to quality care."2

Theoretical Basis

A behavioral change theory is a combination of, "interrelated concepts, definitions, and propositions that present a systematic view of events or situations by specifying relations amount variables, in order to explain or predict the events or situations". By grounding an intervention in theory, the component parts are intentionally sequenced to build off of one another to facilitate a change in health behavior.

Intervention Components and Activities

In the Peer Linkage and Re-engagement intervention, HIV-positive peers:

  • Link WoC who have recently been diagnosed with HIV to HIV primary care; and
  • Re-engage HIV-positive WoC who have fallen out of care (have not attended an HIV primary medical appointment in the last 6 months) back into HIV primary care.

Staffing Requirements

The following staff positions need to be developed and filled in order to successfully implement the intervention and contribute to the multi-site evaluation.

Programmatic Requirements

The following are programmatic requirements that need to be addressed prior to implementation in order to facilitate a successful intervention:

Costs

There is no published information about the cost of peer interventions in linking PLWHA into HIV primary medical care. A recent study examined five navigation-like interventions which used a variety of community level approaches including peer/patient navigation estimated the cost to range from $97 to $536 per month per patient from a provider perspective and $44 to $545 per month per patient from a societal perspective.25

Resources

Overview of prior SPNS initiatives

References

The following source documents were cited in the Intervention document: