Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA.
Department of Health Behavior, Gillings Global School of Public Health, University of North Carolina, Chapel Hill, North Carolina, USA.
BMC Health Serv Res. 2022 Jan 11;22(1):56. doi: 10.1186/s12913-021-07439-4.
Despite evidence on peer navigation's association with positive HIV outcomes, such as engagement in HIV care and antiretroviral therapy (ART) initiation, the mechanisms through which peer navigation may influence these outcomes have been less explored. The purpose of this study is to describe the role of peer navigation and support on enhancing the quality of HIV treatment and care services experienced by female sex workers (FSWs).
Survey data was derived from a quantitative cohort (n = 211) of FSWs living with HIV in the Dominican Republic and complemented with data from two rounds of in-depth interviews (IDIs) from a qualitative subsample (n = 20 per round). Descriptive statistics and multivariable logistic regressions were used to explore the association between peer navigation and relational aspects of care and overall satisfaction of the quality of HIV treatment and care. Thematic analysis was employed to code and synthesize textual data from IDIs.
41.2% of the participants reported having had contact with a peer navigator in the last 6 months. Qualitative data revealed that peer navigation and support was instrumental in assisting FSWs linkage to HIV care after diagnosis, elevating FSWs' ability to access more comprehensive clinical care facilities, and promoting agency by improving FSWs' skills to more strategically and effectively engage with the clinic environment and health care providers. Peer navigation was positively associated with experiencing more respectful treatment by clinic staff (AOR: 6.65, 95% CI: 2.32-19.02), and greater satisfaction with overall HIV care services (AOR: 2.57, 95% CI: 1.77-3.74).
Promoting the full integration of peer navigation into healthcare structures is a strategic approach to enhance the quality of HIV care experienced by FSWs and improve their HIV-related outcomes.
尽管有证据表明同伴导航与积极的 HIV 结果相关，如参与 HIV 护理和抗逆转录病毒治疗 (ART) 的启动，但同伴导航如何影响这些结果的机制尚未得到充分探索。本研究的目的是描述同伴导航和支持在提高接受艾滋病毒感染的性工作者 (FSW) 治疗和护理服务质量方面的作用。
调查数据来自多米尼加共和国的一项 HIV 感染 FSW 定量队列研究（n=211），并辅以来自两轮深度访谈（IDI）的定性子样本数据（每轮 n=20）。描述性统计和多变量逻辑回归用于探索同伴导航与护理的关系方面以及 HIV 治疗和护理质量的总体满意度之间的关联。主题分析用于对 IDI 中的文本数据进行编码和综合。
41.2%的参与者报告在过去 6 个月内与同伴导航员有过接触。定性数据显示，同伴导航和支持在协助 FSW 在诊断后与 HIV 护理联系方面发挥了重要作用，提高了 FSW 获得更全面临床护理设施的能力，并通过提高 FSW 的技能，以更具战略性和有效地参与诊所环境和医疗保健提供者，促进了机构的发展。同伴导航与更尊重诊所工作人员的治疗（AOR：6.65，95%CI：2.32-19.02）和对整体 HIV 护理服务更满意（AOR：2.57，95%CI：1.77-3.74）呈正相关。
促进同伴导航完全融入医疗保健结构是一种提高 FSW 体验的 HIV 护理质量和改善其 HIV 相关结果的战略方法。
