Navigating Quality of Life: effects of a peer navigation program for PLHIV in Australia

Title

Navigating Quality of Life: effects of a peer navigation program for PLHIV in Australia

Presenter

Graham Brown

Authors

T. Krulic (1,2), G. Brown * (3), A. Bourne (4), S. Graham (5)

Institutions

(1) La Trobe University, The Australian Research Centre in Sex, Health and Society, Bundoora, Australia, (2) Living Positive Victoria, Health Promotion, Southbank, Australia, (3) University of New South Wales, Centre for Social Impact, Kensington, Australia, (4) La Trobe University, Australian Research Centre in Sex, Health and Society, Bundoora, Australia, (5) Living Positive Victoria, Peer Support, Southbank, Australia

BACKGROUND: This paper explores the effects of a Peer Navigation Program (PNP) employing peer workers living with HIV to support the Quality of Life (QoL) of PLHIV in Victoria.
METHODS: Our research took a community participatory approach, using mixed methods to observe program delivery and effects in real-world settings. Interviews with 27 clients were conducted July-October 2020, transcribed and thematically analysed. We also report analyses from the responses of a separate cohort of 36 clients to a validated measure of QoL (PozQoL), administered through a survey completed following first appointment and repeated at 2 and 4 months, between December 2018-2020. Multiple linear regressions tested the significance of the relationship between time since baseline and changes in PozQol scores. Covariates were age, gender, sexuality and whether participants were Australian born.
RESULTS: Interviews showed evidence that the PNP provided information, emotional support, positive identification and appraisal, which reduced felt stigma, social isolation and health-related concerns for newly diagnosed PLHIV. Timely linkage to community services and networks, migration and psychological services further supported psychosocial wellbeing and addressed concerns related to themes of life goals and expectations. For participants who experienced discrimination in the migration system and high levels of social isolation and stigma in the community, the impact of an HIV diagnosis on life goals and expectations was more enduring.
Clients were able to access the PNP via phone or online during COVID-19 restrictions. Participants received welfare checks and help with access to medications and income support, but experienced challenges maintaining employment, social support and other activities which supported QoL.
Changes in PozQol scores were not statistically significant. Prior to COVID-19, PozQoL scores indicated improvements in social, functional, psychological and health concern domains. However, this plateaued during COVID-19 restrictions. Our ability to test for significance was limited by sample and effect size.
CONCLUSIONS: Our study found consistent qualitative evidence to suggest that the activities and strategies employed by the PNP can improve factors related to QoL. Our ability to test the significance of observed improvement in PozQol scores was limited by confounders and sample size. These findings guide the aims, scope, activities and evaluation of similar programs.

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