The Role of Peer Groups in HIV Case Finding, Diagnosis, Care, and Treatment: A Qualitative Study

Abstract

People living with HIV increasingly participate as community health workers in supporting the HIV care continuum. Evidence suggests that peer interventions can reduce risky behaviors related to HIV transmission, provide relevant HIV education, and promote healthier lifestyles. In addition to HIV knowledge, peer supporters must be trained on their professional roles within clinical teams, appropriate boundaries, confidentiality practices, referral procedures, and self-care strategies in workplace settings. Conducting such studies in regions where peer interventions are underexplored can generate valuable insights and contribute to more precise reporting at both regional and international levels. A group of HIV-positive individuals, serving as peer supporters-non-clinical health advocates from within the affected community-were recruited after providing written informed consent and assurances of confidentiality. Eligibility required affirmative responses to two screening questions: "Are you willing to participate in this study?" and "Have you been serving as a peer supporter for more than six months?" A baseline survey was conducted to gather socio-demographic information (age, race/ethnicity, gender, education, prior work experience), assess HIV-related knowledge and understanding of peer roles, and document the specific activities peers perform. Additionally, data were collected on HIV self-care behaviors, including healthcare utilization, medication adherence, and risk-reduction practices. Knowledge domains included questions on viral life cycle, antiretroviral therapy and resistance, harm reduction strategies, and treatment adherence. Peer roles were assessed across various domains, including workplace expectations, boundaries, confidentiality, counselling, healthcare navigation, teamwork, communication with healthcare providers, peer readiness, and self-care. Communication skills were further evaluated based on stages of change, active listening, open-ended questioning, cultural awareness, and non-judgmental behaviors. A total of 7 participants (2 women [28.57%] and five men [71.42%]) were enrolled, with a mean age of 47.14 years. The mean duration since HIV diagnosis was approximately 12.19 years. Participants had an average peer work experience of about 9 months. All participants (100%) confirmed that peer supporters' involvement played a positive, essential role in patient diagnosis, support, and follow-up in HIV care. The findings of this study suggest that peer group involvement has a positive and significant impact on the process of HIV diagnosis, treatment, and follow-up care.