Peer Support and HIV/AIDS: Research and Practice
Clayton Velicer, MPH
In advance of next week’s webinar (Thursday, January 30) on the use of Motivation Interviewing in peer support for persons living with HIV, this blog highlights some recent research and support programs for those living with HIV/AIDs.
Past Research Shows Benefits of Peer Support and Education
In research, there have been several positive findings for the role of peers in HIV prevention and for those living with HIV/AIDS. Medley and Colleagues conducted a systematic review that included 30 studies of peer education programs for HIV prevention. The author’s concluded the peer education interventions were significantly associated with increased HIV knowledge, reduced equipment sharing, and increased condom usage.
For those already living with HIV/AIDS, Simoni and Colleagues found that peer support had positive short-term effects on increasing medication adherence within an adult population in Seattle. Qualitative research by Marino and Colleagues reported that participants in peer support programs for increased medication adherence expressed increased acceptance, personal growth, and empowerment.
However, a brief review of this existing literature also underscores the need for additional research on the effectiveness of peer support for preventing HIV and providing support to those already living with HIV/AIDS.
The Silver Project in California
Fortunately, models for incorporating peer support into the care of patients living with HIV/AIDS continue to be evaluated in many programs around the world.
Research underway in California comes as part of $6.4 million that was awarded to five California health care provider organizations in 2010. The grants were provided to study new models of health care delivery to improve quality of care and reduce costs for people with HIV/AIDS.
One of the programs, the Silver Project, integrates HIV and aging care services to address the complex needs of persons 50 years and older living with HIV. The Silver Project is a collaborative effort between the San Francisco Department of Public Health, the UCSF Positive Health Program at San Francisco General Hospital, and 360: The Positive Care Center at UCSF.
Participants in this project undergo a baseline assessment that covers topics like physical and mental health, oral health, and sexual health. Depending on the assessment results, participants are placed in one of three groups. Those doing relatively well are placed in the wellness group and are given basic services, while the rest are placed in either moderate or intensive groups to receive more specialized attention.
In the coming months, the Silver Project will begin testing two strategies with cohorts of participants that are dealing with depression and issues of loneliness and isolation. One strategy employs a support group, in coordination with the Shanti Project, that helps provide peer support services. This program focuses on peer bonding, and emphasizes making contacts and lasting connections with other HIV+ individuals. The second treatment strategy being evaluated is a home-based individualized visit with a psychiatrist.
Dr. Malcolm John, Director of 360: The Positive Care Center at UCSF, explained the need to incorporate the strategies of peer support and home-based visits:
“For things like loneliness and isolation, those are things not well characterized. We don’t have the interventions to effectively address that for patients.”
Dr. John also added that preliminary findings for Silver Project participants underscored the need for medical programs to integrate aging with HIV care and that it requires “a lot of work to integrate into our medical model and make this part of routine annual care.”
Peers for Progress will continue to highlight the valuable role that peer support can play for persons living with HIV/AIDS. Methods for incorporating this support into existing care will continue to be discussed. We encourage our readers interested in this topic to attend our webinar on January 30th.