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Chang K, Wu Y, Shan S, Han S, Wang X, Wu D, Quan X, Han J, Zhang L. Exploring the experiences of peer support participation for HIV peer volunteers: A meta-synthesis of qualitative research. Int J Nurs Stud 2024; 153:104715. [PMID: 38447487 DOI: 10.1016/j.ijnurstu.2024.104715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 12/14/2023] [Accepted: 02/01/2024] [Indexed: 03/08/2024]
Abstract
BACKGROUND Gaining insights and feedback from HIV peer volunteers about their peer support practice is crucial for optimizing and enhancing the effectiveness and sustainability of peer support for people with HIV. There is a dearth of systematic reviews that explore the experiences of HIV peer volunteers about their peer support experience. This study aims to consolidate qualitative research on the experiences of peer support participation for HIV peer volunteers, to provide inspiration and reference for HIV peer support practice. METHODS A meta-aggregation approach was employed to synthesize qualitative studies. Electronic databases were searched for peer-reviewed and gray literature published in English and Chinese between 1996 and September 2022. Two independent reviewers assessed the methodological quality and extracted data from the included studies. The meta-aggregation approach developed by the Joanna Briggs Institute (JBI) was utilized to synthesize the findings. RESULTS A total of 2610 studies were initially identified through the database search, and twenty-two eligible studies were included in the meta-synthesis. Among the included studies, five presented synthesized findings on the following topics: firstly, taking people with HIV as HIV peer volunteers shows specific motivations and advantages when engaging in peer support practice. Secondly, HIV peer volunteers reinforce the connections between people with HIV and medical institutions, ensuring continuity of care and compensating for the limited availability of medical resources. Thirdly, HIV peer volunteers are capable of providing people with HIV with a higher level of support. Additionally, participating in peer support practice can also yield personal benefits for HIV peer volunteers. Finally, HIV peer support programs face both opportunities and challenges. CONCLUSION It is necessary to take more flexible and effective approaches to address resource allocation and social support for people with HIV. Peer support presents a mutually beneficial option that holds significant implications for public health systems, clinical healthcare providers, people with HIV, and HIV peer volunteers. It is imperative to develop effective models for HIV peer support practice. Collaborative efforts between relevant departments and personnel, alongside HIV peer volunteers, should be undertaken to formulate support strategies. Additionally, efforts should be made to identify and guide people with HIV into the healthcare system, facilitating comprehensive treatment and care continuity. These measures aim to further reduce HIV transmission, improve the quality of life for people with HIV, and advance the "normalization" of HIV.
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Affiliation(s)
- Keyi Chang
- Department of Infection, Beijing Youan Hospital Affiliated with Capital Medical University, Beijing, China
| | - Yangfeng Wu
- School of Nursing, Peking University, Beijing, China
| | - Sikai Shan
- School of Nursing, Peking University, Beijing, China
| | - Shuyu Han
- School of Nursing, Peking University, Beijing, China.
| | - Xiaomeng Wang
- School of Nursing, Peking University, Beijing, China
| | - Dongxia Wu
- Department of Infection, Beijing Youan Hospital Affiliated with Capital Medical University, Beijing, China
| | - Xiaoli Quan
- Department of Infection, Beijing Youan Hospital Affiliated with Capital Medical University, Beijing, China
| | - Jianing Han
- Department of Infection, Beijing Youan Hospital Affiliated with Capital Medical University, Beijing, China
| | - Lili Zhang
- Department of Nursing, Beijing Youan Hospital Affiliated with Capital Medical University, Beijing, China.
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Han S, Zhang Y, Yang X, Chai X, Guo J, Zhang L, Shao Y, Ma J, Li K, Wang Z. The effectiveness and sustainability of peer support interventions for persons living with HIV: a realist synthesis. BMJ Glob Health 2023; 8:bmjgh-2022-010966. [PMID: 36804731 PMCID: PMC9943909 DOI: 10.1136/bmjgh-2022-010966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 02/08/2023] [Indexed: 02/22/2023] Open
Abstract
BACKGROUND Peer support is an important supplement to medical resources for persons living with HIV (PLHIV). However, previous studies have shown mixed results about intervention effects. It is necessary to explain the mechanism of peer support interventions' effectiveness and sustainability to help design more valid peer support interventions. OBJECTIVE To identify and explain the mechanisms that drive the effectiveness and maintain the sustainability of peer support interventions. METHODS A preliminary theoretical framework was developed through a scoping review of the grey literature and international project frameworks in five professional websites. We then refined the framework by systematically searching evidence in databases including PubMed, EMBASE, Web of Science, ProQuest, CINAHL, CNKI and Wanfang. Qualitative methods were used to generate codes and themes relating to the studies' context, mechanisms and outcomes. We checked chains of inference (connections) across extracted data and themes through an iterative process. RESULTS A total of 6345 articles were identified, and 52 articles were retained for final synthesis. The refined theoretical framework presents five areas of peer support, including informational support, instrumental support, emotional support, affiliational support and appraisal support; five types of outcomes that peer support can improve for PLHIV, including physiological outcomes, psychological outcomes, behavioural outcomes, cognitive outcomes and social outcomes; the effectiveness mechanism coding system from peer volunteers and the relationship between peer volunteers and PLHIV; and the sustainability mechanism coding system in terms of peer volunteers, PLHIV and study context. CONCLUSIONS Given that peer support has huge potential human resources, that is, all the qualified PLHIV, irreplaceable advantages in dealing with barriers to HIV-related discrimination and potential comprehensive benefits for PLHIV, it is necessary to develop and organise more peer support projects for PLHIV. Our study highlights that the expansion of peer support projects should be based on their effectiveness and sustainability. PROSPERO REGISTRATION NUMBER CRD42022339079.
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Affiliation(s)
- Shuyu Han
- School of Nursing, Peking University, Beijing, People's Republic of China
| | - Yizhu Zhang
- School of Nursing, Peking University, Beijing, People's Republic of China
| | - Xianxia Yang
- School of Public Health, Wuhan University, Wuhan, Hubei, People's Republic of China
| | - Xinru Chai
- School of Nursing, Peking University, Beijing, People's Republic of China
| | - Jinzheng Guo
- School of Nursing, Peking University, Beijing, People's Republic of China
| | - Lili Zhang
- Department of Nursing, Beijing Youan Hospital Affiliated with Capital Medical University, Beijing, People's Republic of China
| | - Ying Shao
- Department of Infection, Beijing Youan Hospital Affiliated with Capital Medical University, Beijing, People's Republic of China
| | - Jianhong Ma
- Department of Infection, Beijing Youan Hospital Affiliated with Capital Medical University, Beijing, People's Republic of China
| | - Ke Li
- Department of Emergency, Peking University First Hospital, Beijing, People's Republic of China
| | - Zhiwen Wang
- School of Nursing, Peking University, Beijing, People's Republic of China
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Øgård-Repål A, Berg RC, Fossum M. A Scoping Review of the Empirical Literature on Peer Support for People Living with HIV. J Int Assoc Provid AIDS Care 2021; 20:23259582211066401. [PMID: 34919006 PMCID: PMC8725019 DOI: 10.1177/23259582211066401] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
People living with HIV receiving antiretroviral therapy need support related to linkage to care and self-management in everyday life. Peer support has been found to provide varied support according to the unique needs of the group. This scoping review aims to provide an overview of research on peer support provided to people living with HIV. A search was conducted in eight databases until May 2021, and two reviewers independently screened all identified studies. We sorted the included studies into categories and conducted descriptive analyses. For this communication, we included 34 studies representing three study categories: the experiences of peer support (n = 23), program descriptions (n = 6), and training of peer supporters (n = 5). The studies were published between 2000 and 2021 and included 4275 participants from 10 countries. The flexibility of peer support complements healthcare services, but there is a need to clarify and adjust the ongoing support when living with HIV.
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Affiliation(s)
| | - Rigmor C Berg
- 25563Norwegian Institute of Public Health, Oslo, Norway, and University of Tromsø, Tromsø, Norway
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Berg RC, Page S, Øgård-Repål A. The effectiveness of peer-support for people living with HIV: A systematic review and meta-analysis. PLoS One 2021; 16:e0252623. [PMID: 34138897 PMCID: PMC8211296 DOI: 10.1371/journal.pone.0252623] [Citation(s) in RCA: 61] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Accepted: 05/19/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The practice of involving people living with HIV in the development and provision of healthcare has gained increasing traction. Peer-support for people living with HIV is assistance and encouragement by an individual considered equal, in taking an active role in self-management of their chronic health condition. The objective of this systematic review was to assess the effects of peer-support for people living with HIV. METHODS We conducted a systematic review in accordance with international guidelines. Following systematic searches of eight databases until May 2020, two reviewers performed independent screening of studies according to preset inclusion criteria. We conducted risk of bias assessments and meta-analyses of the available evidence in randomised controlled trials (RCTs). The certainty of the evidence for each primary outcome was evaluated with the Grading of Recommendations Assessment, Development, and Evaluation system. RESULTS After screening 219 full texts we included 20 RCTs comprising 7605 participants at baseline from nine different countries. The studies generally had low risk of bias. Main outcomes with high certainty of evidence showed modest, but superior retention in care (Risk Ratio [RR] 1.07; Confidence Interval [CI] 95% 1.02-1.12 at 12 months follow-up), antiretroviral therapy (ART) adherence (RR 1.06; CI 95% 1.01-1.10 at 3 months follow-up), and viral suppression (Odds Ratio up to 6.24; CI 95% 1.28-30.5 at 6 months follow-up) for peer-support participants. The results showed that the current state of evidence for most other main outcomes (ART initiation, CD4 cell count, quality of life, mental health) was promising, but too uncertain for firm conclusions. CONCLUSIONS Overall, peer-support with routine medical care is superior to routine clinic follow-up in improving outcomes for people living with HIV. It is a feasible and effective approach for linking and retaining people living with HIV to HIV care, which can help shoulder existing services. TRIAL REGISTRATION CRD42020173433.
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Affiliation(s)
- Rigmor C. Berg
- Division for Health Services, Norwegian Institute of Public Health, Oslo, Norway
- Institute of Community Medicine, University of Tromsø, Tromsø, Norway
| | | | - Anita Øgård-Repål
- Department of Nursing and Health Science, University of Agder, Kristiansand, Norway
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Hoopes AJ, Agarwal P, Bull S, Chandra-Mouli V. Measuring adolescent friendly health services in India: A scoping review of evaluations. Reprod Health 2016; 13:137. [PMID: 27846848 PMCID: PMC5111259 DOI: 10.1186/s12978-016-0251-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Accepted: 10/28/2016] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Initiatives to promote adolescent friendly health services (AFHS) have been taking place in India and many low- and middle-income countries for nearly two decades. Evaluations of these initiatives have been placed in the public arena from time to time, but little is known about what they say about the overall situation on AFHS in India. This study aimed to describe how efforts to provide AFHS in India have been evaluated, how well they have been evaluated, and what their findings and implications are. METHODS We conducted a scoping review of evaluations of AFHS initiatives in India from 2000 to 2014. An electronic search was carried out in Medline and EMBASE. A manual search of grey literature was also performed, and experts were contacted in order to obtain additional manuscripts and reports. RESULTS Thirty evaluation reports were identified representing a broad geographic distribution. Evaluations have focused on government-sponsored AFHS programmes or independent non-governmental organization (NGO) initiatives to strengthen government services. The evaluations primarily measured programme outputs (e.g. quality and service utilization) and health behavioural outcomes (e.g. condom use). Study designs were commonly descriptive or quasi-experimental. Most evaluations found improvement in quality and utilization of services, and some demonstrated an increase in adolescent knowledge or health behaviours. Few measured positive project/programme results such as older age at first pregnancy. Strengths of evaluations were clear objectives, frequent use of multiple data sources, and assessment of programmatic outputs as well as health outcomes. Weaknesses were lack of consistency and quality. CONCLUSIONS Our findings confirm that a number of evaluations of AFHS initiatives in India have been carried out. They point to service quality and in behavioural improvements in adolescents. However, their lack of consistency hinders comparison across sites, and their uneven quality means that their findings need to be interpreted with caution.
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Affiliation(s)
- Andrea J. Hoopes
- Department of Pediatrics, University of Colorado School of Medicine, 13123 East 16th Avenue, Box B025, Aurora, CO USA
| | - Paras Agarwal
- Department of Community Medicine, Maulana Azad Medical College, New Delhi, India
| | - Sheana Bull
- Department of Community and Behavioral Health, Colorado School of Public Health, 13001 E. 17th Place, B119, Bldg 500, Room E3345A, Aurora, CO 80045 USA
- Anschutz Medical Campus, Aurora, CO 80045 USA
| | - Venkatraman Chandra-Mouli
- Division of Reproductive Health and Research, World Health Organization, Avenue Appia 20, 1211 Geneva 27, Switzerland
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McClarty LM, Lorway RR, Ramanaik S, Wylie J, Becker ML. Factors influencing frontline health service providers' likelihood to recommend a future, preventive HIV vaccine to key populations in Karnataka, south India. Vaccine 2014; 33:656-63. [PMID: 25528520 DOI: 10.1016/j.vaccine.2014.12.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2014] [Revised: 12/03/2014] [Accepted: 12/05/2014] [Indexed: 11/29/2022]
Abstract
The HIV epidemic in the south Indian state of Karnataka disproportionately burdens key populations of men who have sex with men and female sex workers. Despite having successfully reduced HIV incidence among certain key populations through the use of targeted intervention, India's HIV epidemic remains one of its greatest public health issues. The best long-term strategy for managing the global HIV epidemic might involve a preventive vaccine; however, vaccine availability cannot guarantee its accessibility or acceptability. Vaccine recommendations from frontline health service providers have previously been identified as useful strategies to enhance vaccine uptake among target groups. This study used structured interviews to explore frontline health service providers' self-identified likelihood to recommend a future, preventive HIV vaccine to key populations in Karnataka. A modified social ecological model was then used to categorise factors that might prevent health service providers from recommending an HIV vaccine. Overall, 83% of health service providers reported that they would be very likely to recommend an HIV vaccine to men who have sex with men and female sex workers, while less than one-third of participants identified one or more barrier to vaccine recommendation. Intrapersonal, interpersonal, and structural/political factors were most commonly reported to act as potential barriers to future HIV vaccine recommendation among health service providers in Karnataka. This study adds to the limited body of literature focussing on future HIV vaccine acceptability in low- and middle-income countries and highlights some of the several complexities surrounding vaccine acceptability and uptake among key populations in Karnataka.
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Affiliation(s)
- Leigh M McClarty
- Centre for Global Public Health, Department of Community Health Sciences, University of Manitoba, R070 Medical Rehabilitation Building, 771 McDermot Avenue, Winnipeg, Manitoba R3E 0T6, Canada.
| | - Robert R Lorway
- Centre for Global Public Health, Department of Community Health Sciences, University of Manitoba, R070 Medical Rehabilitation Building, 771 McDermot Avenue, Winnipeg, Manitoba R3E 0T6, Canada.
| | - Satyanarayana Ramanaik
- Karnataka Health Promotion Trust, IT Park, #1-4, 5th Floor, Rajajinagar Industrial Area, Rajajinagar, Bangalore, 560044, India.
| | - John Wylie
- Department of Medical Microbiology, University of Manitoba, 543 Basic Medical Sciences Building, 745 Bannatyne Avenue, Winnipeg, Manitoba R3E 0J9, Canada; Department of Community Health Sciences, University of Manitoba, S113 Medical Services Building, 750 Bannatyne Avenue, Winnipeg, Manitoba R3E 0W3, Canada.
| | - Marissa L Becker
- Centre for Global Public Health, Department of Community Health Sciences, University of Manitoba, R070 Medical Rehabilitation Building, 771 McDermot Avenue, Winnipeg, Manitoba R3E 0T6, Canada; Department of Community Health Sciences, University of Manitoba, S113 Medical Services Building, 750 Bannatyne Avenue, Winnipeg, Manitoba R3E 0W3, Canada.
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Singla D, Lazarus A, Atif N, Sikander S, Bhatia U, Ahmad I, Nisar A, Khan S, Fuhr D, Patel V, Rahman A. "Someone like us": delivering maternal mental health through peers in two South Asian contexts. J Affect Disord 2014; 168:452-8. [PMID: 25113958 PMCID: PMC4157588 DOI: 10.1016/j.jad.2014.07.017] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Accepted: 07/08/2014] [Indexed: 11/16/2022]
Abstract
BACKGROUND Peer-led psychosocial interventions are one solution to address the great paucity of skilled mental health human resources in South Asia. The aim of this study was to explore peer-delivered care for maternal depression in two diverse contexts in South Asia. METHODS The study was carried out in the urban setting of Goa, India and rural setting in Rawalpindi, Pakistan. In total, 61 in-depth interviews (IDIs) and 3 focus group discussions (FGDs), and 38 IDIs and 10 FGDs, were conducted with multiple stakeholders in urban Goa and rural Rawalpindi respectively. We used the framework approach to analyze data. RESULTS Peers from the same community were the most preferred delivery agents of a community-based psychosocial intervention in both sites. There were contextual similarities and differences between the two sites. Preferred characteristics among peers included local, middle-aged, educated mothers with similar experiences to participants, good communication skills and a good character. Key differences between the two contexts included a greater emphasis on the peer׳s family social standing in rural Rawalpindi and financial incentives as motivators for individual peers in urban Goa. LIMITATIONS Generalizability of our findings is limited to two specific contexts in a vast and diverse region. DISCUSSION Our study demonstrates that peers have the potential to deliver maternal psychosocial interventions in low-income settings. There are contextual differences in the preferred characteristics and motivators between the sites, and these should be carefully considered in program implementation.
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Affiliation(s)
- Daisy Singla
- 1205 Avenue Docteur Penfield, Department of Psychology, McGill University, Montreal Quebec, Canada H3A 1B1.
| | | | - Najia Atif
- Human Development Research Foundation, Pakistan
| | | | - Urvita Bhatia
- Sangath Center, Succour, Porvorim, Bardez, Goa 403501
| | | | - Anum Nisar
- Human Development Research Foundation, Pakistan
| | - Sonia Khan
- Human Development Research Foundation, Pakistan
| | - Daniela Fuhr
- Centre for Global Mental Health, London School of Hygiene & Tropical Medicine, Keppel Street, London, United Kingdom WC1E7HT
| | - Vikram Patel
- Sangath Center, Succour, Porvorim, Bardez, Goa 403501,Centre for Global Mental Health, London School of Hygiene & Tropical Medicine, Keppel Street, London, United Kingdom WC1E7HT,Center for Chronic Conditions and Injuries, Public Health Foundation of India, New Delhi
| | - Atif Rahman
- Human Development Research Foundation, Pakistan; Institute of Psychology, Health and Society, University of Liverpool, Liverpool L69 3BX, United Kingdom.
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