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

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Abstract

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.

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Acknowledgments

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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Authors and Affiliations

  1. Department of Health Services, Policy & Practice, Brown University, 121 S. Main Street, Box G-121-6, Providence, RI, 02912, USA

    Becky L. Genberg

  2. Department of Behavioral and Social Sciences, Brown University, Providence, RI, USA

    Sylvia Shangani, Kelly Sabatino & Don Operario

  3. The Ontario HIV Treatment Network, Toronto, Canada

    Beth Rachlis

  4. Dalla Lana School of Public Health, University of Toronto, Toronto, Canada

    Beth Rachlis & Paula Braitstein

  5. Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya

    Juddy Wachira & Paula Braitstein

  6. Department of Medicine, Moi University College of Health Sciences, School of Medicine, Eldoret, Kenya

    Juddy Wachira & Paula Braitstein

  7. Fairbanks School of Public Health, Indiana University, Indianapolis, IN, USA

    Paula Braitstein

  8. Regenstrief Institute, Indianapolis, IN, USA

    Paula Braitstein

Authors
  1. Becky L. Genberg
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  2. Sylvia Shangani
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  3. Kelly Sabatino
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  4. Beth Rachlis
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  5. Juddy Wachira
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  6. Paula Braitstein
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  7. Don Operario
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Corresponding author

Correspondence to Becky L. Genberg.

Appendix

Appendix

See Table 4.

Table 4 Search terms used by search engine (PubMed, CINAHL, PsycINFO)
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Genberg, B.L., Shangani, S., Sabatino, K. et al. Improving Engagement in the HIV Care Cascade: A Systematic Review of Interventions Involving People Living with HIV/AIDS as Peers. AIDS Behav 20, 2452–2463 (2016). https://doi.org/10.1007/s10461-016-1307-z

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  • DOI: https://doi.org/10.1007/s10461-016-1307-z

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