AIDS and Behavior

, Volume 20, Issue 10, pp 2452–2463 | Cite as

Improving Engagement in the HIV Care Cascade: A Systematic Review of Interventions Involving People Living with HIV/AIDS as Peers

  • Becky L. Genberg
  • Sylvia Shangani
  • Kelly Sabatino
  • Beth Rachlis
  • Juddy Wachira
  • Paula Braitstein
  • Don Operario
Original Paper


Improving patient engagement in HIV care is critical for maximizing the impact of antiretroviral therapy (ART). We conducted a systematic review of studies that used HIV-positive peers to bolster linkage, retention, and/or adherence to ART. We searched articles published and indexed in Pubmed, PsycINFO, and CINAHL between 1996 and 2014. Peers were required to be HIV-positive. Studies were restricted to those published in English. Nine studies with n = 4658 participants met the inclusion criteria. Peer-based interventions were predominantly focused on improving adherence to ART, or evaluations of retention and adherence via viral suppression. Five (56 %) were conducted in sub-Saharan Africa. Overall findings were mixed on the impact of peers on ART adherence, viral suppression, and mortality. While positive effects of peer interventions on improving linkage and retention were found, there were limited studies assessing these outcomes. Additional research is warranted to demonstrate the impact of peers on linkage and retention in diverse populations.


Peer interventions Linkage to HIV care Retention in HIV care Antiretroviral adhernce Systematic review Sub-Saharan Africa 



This research was supported by the National Institute of Mental Health (K01MH099966), the National Institute of Allergy and Infectious Diseases (R21AI116309), and the National Institute of Child Health and Development (R24HD077976).


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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Becky L. Genberg
    • 1
  • Sylvia Shangani
    • 2
  • Kelly Sabatino
    • 2
  • Beth Rachlis
    • 3
    • 4
  • Juddy Wachira
    • 5
    • 6
  • Paula Braitstein
    • 4
    • 5
    • 6
    • 7
    • 8
  • Don Operario
    • 2
  1. 1.Department of Health Services, Policy & PracticeBrown UniversityProvidenceUSA
  2. 2.Department of Behavioral and Social SciencesBrown UniversityProvidenceUSA
  3. 3.The Ontario HIV Treatment NetworkTorontoCanada
  4. 4.Dalla Lana School of Public HealthUniversity of TorontoTorontoCanada
  5. 5.Academic Model Providing Access to Healthcare (AMPATH)EldoretKenya
  6. 6.Department of MedicineMoi University College of Health Sciences, School of MedicineEldoretKenya
  7. 7.Fairbanks School of Public HealthIndiana UniversityIndianapolisUSA
  8. 8.Regenstrief InstituteIndianapolisUSA

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