Skip to main content
Top
Published in: Journal of Community Health 6/2010

Open Access 01-12-2010 | Original Paper

Peer Knowledge and Roles in Supporting Access to Care and Treatment

Authors: Carol R. Tobias, Serena Rajabiun, Julie Franks, Sarah B. Goldenkranz, David N. Fine, Brenda S. Loscher-Hudson, Paul W. Colson, Sharon M. Coleman

Published in: Journal of Community Health | Issue 6/2010

Login to get access

Abstract

People living with HIV (PLWHIV) have been involved in the continuum of HIV care since the early days of the epidemic providing education and prevention services. There is a growing interest in utilizing HIV positive peers to support access to care and treatment, but little is known about the range of roles these peers perform and what they need to know to do this work. This study of 186 HIV-positive peers currently providing community health services in eight states found that peers perform a wide range of roles, including assistance with care and treatment, emotional support, and service referrals. Over 80% discussed medications with clients. On average, experienced peers provided correct responses to 73% of questions about HIV and AIDS, and 65% of questions about the appropriate role of a peer. Peers living with HIV for more than 5 years, in paid employment with more than a high school education had higher HIV knowledge scores than volunteers. Higher education, length of time living with HIV, age and speaking English as the primary language were associated with higher peer knowledge scores. This study suggests that we cannot assume that peers already working in the field are fully knowledgeable about HIV care and treatment or peer roles. It is important to address gaps in knowledge through continuing education and to create common standards for the training and skills that peers who work in community health settings need to have.
Literature
1.
go back to reference Latkin, C. A., Sherman, S., & Knowlton, A. (2003). HIV prevention among drug users: Outcome of a network-oriented peer outreach intervention. Health Psychology, 22(4), 332–339.CrossRefPubMed Latkin, C. A., Sherman, S., & Knowlton, A. (2003). HIV prevention among drug users: Outcome of a network-oriented peer outreach intervention. Health Psychology, 22(4), 332–339.CrossRefPubMed
2.
go back to reference Medley, A., Kennedy, C., O’Reilly, K., et al. (2009). Effectiveness of peer education interventions for HIV prevention in developing countries: A systematic review and meta-analysis. AIDS Education and Prevention, 21(3), 181–206.CrossRefPubMed Medley, A., Kennedy, C., O’Reilly, K., et al. (2009). Effectiveness of peer education interventions for HIV prevention in developing countries: A systematic review and meta-analysis. AIDS Education and Prevention, 21(3), 181–206.CrossRefPubMed
3.
go back to reference Coyle, S. L., Needle, R. H., & Normand, J. (1998). Outreach-based HIV prevention for injecting drug users: A review of published outcome data. Public Health Reports, 113(Suppl 1), 19–30.PubMed Coyle, S. L., Needle, R. H., & Normand, J. (1998). Outreach-based HIV prevention for injecting drug users: A review of published outcome data. Public Health Reports, 113(Suppl 1), 19–30.PubMed
4.
go back to reference Birkel, R. C., Golaszewski, T., Koman, J. J., 3rd, et al. (1993). Findings from the Horizontes acquired immune deficiency syndrome education project: The impact of indigenous outreach workers as change agents for injection drug users. Health Education Quarterly, 20(4), 523–538.PubMed Birkel, R. C., Golaszewski, T., Koman, J. J., 3rd, et al. (1993). Findings from the Horizontes acquired immune deficiency syndrome education project: The impact of indigenous outreach workers as change agents for injection drug users. Health Education Quarterly, 20(4), 523–538.PubMed
5.
go back to reference Turner, G., & Shepherd, J. (1999). A method in search of a theory: Peer education and health promotion. Health Education Research, 14(2), 235–247.CrossRefPubMed Turner, G., & Shepherd, J. (1999). A method in search of a theory: Peer education and health promotion. Health Education Research, 14(2), 235–247.CrossRefPubMed
6.
go back to reference Campbell, C., & Mzaidume, Z. (2001). Grassroots participation, peer education, and HIV prevention by sex workers in South Africa. American Journal of Public Health, 91(12), 1978–1986.CrossRefPubMed Campbell, C., & Mzaidume, Z. (2001). Grassroots participation, peer education, and HIV prevention by sex workers in South Africa. American Journal of Public Health, 91(12), 1978–1986.CrossRefPubMed
7.
go back to reference Cabral, R. J., Galavotti, C., Gargiullo, P. M., et al. (1996). Paraprofessional delivery of a theory based HIV prevention counseling intervention for women. Public Health Reports, 111(Suppl 1), 75–82.PubMed Cabral, R. J., Galavotti, C., Gargiullo, P. M., et al. (1996). Paraprofessional delivery of a theory based HIV prevention counseling intervention for women. Public Health Reports, 111(Suppl 1), 75–82.PubMed
8.
go back to reference Carey, M. P., & Schroder, K. E. (2002). Development and psychometric evaluation of the brief HIV Knowledge Questionnaire. AIDS Education and Prevention, 14(2), 172–182.CrossRefPubMed Carey, M. P., & Schroder, K. E. (2002). Development and psychometric evaluation of the brief HIV Knowledge Questionnaire. AIDS Education and Prevention, 14(2), 172–182.CrossRefPubMed
9.
go back to reference Raja, S., Teti, M., Knauz, R., et al. (2008). Implementing peer-based interventions in clinic-based settings: Lessons from a multi-site HIV prevention with positives initiative. Journal of HIV/AIDS & Social Services, 7(1), 7–26.CrossRef Raja, S., Teti, M., Knauz, R., et al. (2008). Implementing peer-based interventions in clinic-based settings: Lessons from a multi-site HIV prevention with positives initiative. Journal of HIV/AIDS & Social Services, 7(1), 7–26.CrossRef
10.
go back to reference Latkin, C. A., Hua, W., & Davey, M. A. (2004). Factors associated with peer HIV prevention outreach in drug-using communities. AIDS Education and Prevention, 16(6), 499–508.CrossRefPubMed Latkin, C. A., Hua, W., & Davey, M. A. (2004). Factors associated with peer HIV prevention outreach in drug-using communities. AIDS Education and Prevention, 16(6), 499–508.CrossRefPubMed
11.
go back to reference Broadhead, R. S. (1998). Harnessing peer networks for HIV AIDS prevention: The results from a peer driven intervention. Public Health Reports, 113(1), 42–57.PubMed Broadhead, R. S. (1998). Harnessing peer networks for HIV AIDS prevention: The results from a peer driven intervention. Public Health Reports, 113(1), 42–57.PubMed
12.
go back to reference Kalichman, S. C., Rompa, D., Cage, M., et al. (2001). Effectiveness of an intervention to reduce HIV transmission risks in HIV-positive people. American Journal of Preventive Medicine, 21(2), 84–92.CrossRefPubMed Kalichman, S. C., Rompa, D., Cage, M., et al. (2001). Effectiveness of an intervention to reduce HIV transmission risks in HIV-positive people. American Journal of Preventive Medicine, 21(2), 84–92.CrossRefPubMed
13.
go back to reference Kennedy, C., O’Reilly, K., Medley, A., et al. (2007). The impact of HIV treatment on risk behaviour in developing countries: A systematic review. AIDS Care, 19(6), 707–720.CrossRefPubMed Kennedy, C., O’Reilly, K., Medley, A., et al. (2007). The impact of HIV treatment on risk behaviour in developing countries: A systematic review. AIDS Care, 19(6), 707–720.CrossRefPubMed
14.
go back to reference Boyd, M. R., Moneyham, L., Murdaugh, C., et al. (2005). A peer-based substance abuse intervention for HIV + rural women: A pilot study. Archives of Psychiatric Nursing, 19(1), 10–17.CrossRefPubMed Boyd, M. R., Moneyham, L., Murdaugh, C., et al. (2005). A peer-based substance abuse intervention for HIV + rural women: A pilot study. Archives of Psychiatric Nursing, 19(1), 10–17.CrossRefPubMed
15.
go back to reference Wingood, G. M., DiClemente, R. J., Mikhail, I., et al. (2004). A randomized controlled trial to reduce HIV transmission risk behaviors and sexually transmitted diseases among women living with HIV: The willow program. Journal of Acquired Immune Deficiency Syndromes (1999), 37(Suppl 2), S58–S67.CrossRef Wingood, G. M., DiClemente, R. J., Mikhail, I., et al. (2004). A randomized controlled trial to reduce HIV transmission risk behaviors and sexually transmitted diseases among women living with HIV: The willow program. Journal of Acquired Immune Deficiency Syndromes (1999), 37(Suppl 2), S58–S67.CrossRef
16.
go back to reference Harris G. E., Larsen, D. (2007). HIV peer counseling and the development of hope: Perspectives from peer counselors and peer counseling recipients. AIDS Patient Care and STDs. 21(11). Harris G. E., Larsen, D. (2007). HIV peer counseling and the development of hope: Perspectives from peer counselors and peer counseling recipients. AIDS Patient Care and STDs. 21(11).
17.
go back to reference Broadhead, R. S., Heckathorn, D. D., Altice, F. L., et al. (2002). Increasing drug users’ adherence to HIV treatment: Results of a peer-driven intervention feasibility study. Social Science and Medicine, 55(2), 235–246.CrossRefPubMed Broadhead, R. S., Heckathorn, D. D., Altice, F. L., et al. (2002). Increasing drug users’ adherence to HIV treatment: Results of a peer-driven intervention feasibility study. Social Science and Medicine, 55(2), 235–246.CrossRefPubMed
18.
go back to reference Simoni, J. M., Amico, K. R., Pearson, C. R., et al. (2008). Strategies for promoting adherence to antiretroviral therapy: A review of the literature. Current Infectious Disease Reports, 10(6), 515–521.CrossRefPubMed Simoni, J. M., Amico, K. R., Pearson, C. R., et al. (2008). Strategies for promoting adherence to antiretroviral therapy: A review of the literature. Current Infectious Disease Reports, 10(6), 515–521.CrossRefPubMed
19.
go back to reference Deering K. N., Shannon K., Sinclair H., et al. (2009). Piloting a peer-driven intervention model to increase access and adherence to antiretroviral therapy and HIV care among street-entrenched HIV-positive women in Vancouver. AIDS Patient Care and STDs. Deering K. N., Shannon K., Sinclair H., et al. (2009). Piloting a peer-driven intervention model to increase access and adherence to antiretroviral therapy and HIV care among street-entrenched HIV-positive women in Vancouver. AIDS Patient Care and STDs.
20.
go back to reference Mitty, J. A., Huang, D., Loewenthal, H. G., et al. (2007). Modified directly observed therapy: Sustained self-reported adherence and HIV health status. AIDS Patient Care and STDs, 21(12), 897–899.CrossRefPubMed Mitty, J. A., Huang, D., Loewenthal, H. G., et al. (2007). Modified directly observed therapy: Sustained self-reported adherence and HIV health status. AIDS Patient Care and STDs, 21(12), 897–899.CrossRefPubMed
21.
go back to reference Raja, S., McKirnan, D., & Glick, N. (2007). The treatment advocacy program-sinai: A peer-based HIV prevention intervention for working with African American HIV-infected persons. AIDS and Behavior, 11(5 Suppl), S127–S137.CrossRefPubMed Raja, S., McKirnan, D., & Glick, N. (2007). The treatment advocacy program-sinai: A peer-based HIV prevention intervention for working with African American HIV-infected persons. AIDS and Behavior, 11(5 Suppl), S127–S137.CrossRefPubMed
22.
go back to reference Giordano, T. P., Visnegarwala, F., White, A. C., Jr., et al. (2005). Patients referred to an urban HIV clinic frequently fail to establish care: Factors predicting failure. AIDS Care, 17(6), 773–783.CrossRefPubMed Giordano, T. P., Visnegarwala, F., White, A. C., Jr., et al. (2005). Patients referred to an urban HIV clinic frequently fail to establish care: Factors predicting failure. AIDS Care, 17(6), 773–783.CrossRefPubMed
23.
go back to reference Fleming, P. L., Byers, R. H., Sweeney, P. A, et al. (2002). HIV prevalence in the United States, 2000. 9th conference on retroviruses and opportunistic infections. Seattle, WA. Fleming, P. L., Byers, R. H., Sweeney, P. A, et al. (2002). HIV prevalence in the United States, 2000. 9th conference on retroviruses and opportunistic infections. Seattle, WA.
24.
go back to reference Perkins, D., Meyerson, B. E., Klinkenberg, D., et al. (2008). Assessing HIV care and unmet need: Eight data bases and a bit of perseverance. AIDS Care, 20(3), 318–326.CrossRefPubMed Perkins, D., Meyerson, B. E., Klinkenberg, D., et al. (2008). Assessing HIV care and unmet need: Eight data bases and a bit of perseverance. AIDS Care, 20(3), 318–326.CrossRefPubMed
25.
go back to reference Behforouz, H. L., Kalmus, A., Scherz, C. S., et al. (2004). Directly observed therapy for HIV antiretroviral therapy in an urban US setting. Journal of Acquired Immune Deficiency Syndromes, 36(1), 642–645.CrossRefPubMed Behforouz, H. L., Kalmus, A., Scherz, C. S., et al. (2004). Directly observed therapy for HIV antiretroviral therapy in an urban US setting. Journal of Acquired Immune Deficiency Syndromes, 36(1), 642–645.CrossRefPubMed
26.
go back to reference Rumptz, M. H., Tobias, C., Rajabiun, S., et al. (2007). Factors associated with engaging socially marginalized HIV-positive persons in primary care. AIDS Patient Care and STDs, 21(Suppl 1), S30–S39.PubMed Rumptz, M. H., Tobias, C., Rajabiun, S., et al. (2007). Factors associated with engaging socially marginalized HIV-positive persons in primary care. AIDS Patient Care and STDs, 21(Suppl 1), S30–S39.PubMed
27.
go back to reference Behforouz, H. L., Farmer, P. E., & Mukherjee, J. S. (2004). From directly observed therapy to accompagnateurs: Enhancing AIDS treatment outcomes in Haiti and in Boston. Clinical Infectious Diseases, 38(Suppl 5), S429–S436.CrossRefPubMed Behforouz, H. L., Farmer, P. E., & Mukherjee, J. S. (2004). From directly observed therapy to accompagnateurs: Enhancing AIDS treatment outcomes in Haiti and in Boston. Clinical Infectious Diseases, 38(Suppl 5), S429–S436.CrossRefPubMed
28.
go back to reference Tobias, C. R., Cunningham, W., Cabral, H. D., et al. (2007). Living with HIV but without medical care: Barriers to engagement. AIDS Patient Care and STDs, 21(6), 426–434.CrossRefPubMed Tobias, C. R., Cunningham, W., Cabral, H. D., et al. (2007). Living with HIV but without medical care: Barriers to engagement. AIDS Patient Care and STDs, 21(6), 426–434.CrossRefPubMed
29.
go back to reference Beer, L., Fagan, J. L., Valverde, E., et al. (2009). Health-related beliefs and decisions about accessing HIV medical care among HIV-infected persons who are not receiving care. AIDS Patient Care and STDs, 23(9), 785–792.CrossRefPubMed Beer, L., Fagan, J. L., Valverde, E., et al. (2009). Health-related beliefs and decisions about accessing HIV medical care among HIV-infected persons who are not receiving care. AIDS Patient Care and STDs, 23(9), 785–792.CrossRefPubMed
30.
go back to reference Balfour, L., Kowal, J., Tasca, G. A., et al. (2007). Development and psychometric validation of the HIV treatment knowledge scale. AIDS Care, 19(9), 1141–1148.CrossRefPubMed Balfour, L., Kowal, J., Tasca, G. A., et al. (2007). Development and psychometric validation of the HIV treatment knowledge scale. AIDS Care, 19(9), 1141–1148.CrossRefPubMed
31.
go back to reference HRSA. (2004). Peer educator training sites and resource and evaluation center FY 2005 program guidance, Rockville, MD. HRSA. (2004). Peer educator training sites and resource and evaluation center FY 2005 program guidance, Rockville, MD.
32.
go back to reference Marino, P., Simoni, J. M., & Siverstein, L. B. (2007). Peer support to promote medication adherence among people living with HIV/AIDS: The benefit to peers. Social Work in Health Care, 45(1), 67–80.CrossRefPubMed Marino, P., Simoni, J. M., & Siverstein, L. B. (2007). Peer support to promote medication adherence among people living with HIV/AIDS: The benefit to peers. Social Work in Health Care, 45(1), 67–80.CrossRefPubMed
33.
go back to reference Mukherjee, J. S., & Eustache, F. E. (2007). Community health workers as a cornerstone for integrating HIV and primary healthcare. AIDS Care, 19(Suppl 1), S73–S82.CrossRefPubMed Mukherjee, J. S., & Eustache, F. E. (2007). Community health workers as a cornerstone for integrating HIV and primary healthcare. AIDS Care, 19(Suppl 1), S73–S82.CrossRefPubMed
34.
go back to reference Altice, F. L., Mezger, J. A., Hodges, J., et al. (2004). Developing a directly administered antiretroviral therapy intervention for HIV-infected drug users: Implications for program replication. Clinical Infectious Diseases, 38(Suppl 5), S376–S387.CrossRefPubMed Altice, F. L., Mezger, J. A., Hodges, J., et al. (2004). Developing a directly administered antiretroviral therapy intervention for HIV-infected drug users: Implications for program replication. Clinical Infectious Diseases, 38(Suppl 5), S376–S387.CrossRefPubMed
35.
go back to reference Chang, L. W., Alamo, S., Guma, S., et al. (2009). Two-year virologic outcomes of an alternative AIDS care model: Evaluation of a peer health worker and nurse-staffed community-based program in Uganda. Journal of Acquired Immune Deficiency Syndromes, 50(3), 276–282.CrossRefPubMed Chang, L. W., Alamo, S., Guma, S., et al. (2009). Two-year virologic outcomes of an alternative AIDS care model: Evaluation of a peer health worker and nurse-staffed community-based program in Uganda. Journal of Acquired Immune Deficiency Syndromes, 50(3), 276–282.CrossRefPubMed
36.
go back to reference Messias, D. K. H., Moneyham, L., Vyavaharkar, M., et al. (2009). Embodied work: Insider perspectives on the work of HIV/AIDS peer counselors. Health Care for Women International, 30(7), 572–594. Messias, D. K. H., Moneyham, L., Vyavaharkar, M., et al. (2009). Embodied work: Insider perspectives on the work of HIV/AIDS peer counselors. Health Care for Women International, 30(7), 572–594.
37.
go back to reference Goggin, K., Liston, R. J., & Mitty, J. A. (2007). Modified directly observed therapy for antiretroviral therapy: A primer from the field. Public Health Reports, 122(4), 472–481.PubMed Goggin, K., Liston, R. J., & Mitty, J. A. (2007). Modified directly observed therapy for antiretroviral therapy: A primer from the field. Public Health Reports, 122(4), 472–481.PubMed
38.
go back to reference Ananth, P., & Koopman, C. (2003). HIV/AIDS knowledge, beliefs, and behavior among women of childbearing age in India. AIDS Education and Prevention, 15(6), 529–546.CrossRefPubMed Ananth, P., & Koopman, C. (2003). HIV/AIDS knowledge, beliefs, and behavior among women of childbearing age in India. AIDS Education and Prevention, 15(6), 529–546.CrossRefPubMed
39.
go back to reference Nachega, J. B., Lehman, D. A., Hlatshwayo, D., et al. (2005). HIV/AIDS and antiretroviral treatment knowledge, attitudes, beliefs, and practices in HIV-infected adults in Soweto, South Africa. Journal of Acquired Immune Deficiency Syndromes, 38(2), 196–201.CrossRefPubMed Nachega, J. B., Lehman, D. A., Hlatshwayo, D., et al. (2005). HIV/AIDS and antiretroviral treatment knowledge, attitudes, beliefs, and practices in HIV-infected adults in Soweto, South Africa. Journal of Acquired Immune Deficiency Syndromes, 38(2), 196–201.CrossRefPubMed
Metadata
Title
Peer Knowledge and Roles in Supporting Access to Care and Treatment
Authors
Carol R. Tobias
Serena Rajabiun
Julie Franks
Sarah B. Goldenkranz
David N. Fine
Brenda S. Loscher-Hudson
Paul W. Colson
Sharon M. Coleman
Publication date
01-12-2010
Publisher
Springer US
Published in
Journal of Community Health / Issue 6/2010
Print ISSN: 0094-5145
Electronic ISSN: 1573-3610
DOI
https://doi.org/10.1007/s10900-010-9250-9

Other articles of this Issue 6/2010

Journal of Community Health 6/2010 Go to the issue