Valuing expertise: community and clinical collaboration in an Australian HIV peer navigation program

BACKGROUND: Our study examined how a peer navigation program (PNP), integrating insights and practices of peers living with HIV into clinical services, could improve the effectiveness of the HIV service environment in Victoria.
METHODS: We conducted interviews and focus groups with 30 staff from a peer-based community organization implementing the PNP and its clinical partners. Interviews explored the quality of engagement and adaptation across diverse clinical settings and factors that influenced the program's effectiveness. Data were transcribed and thematically analysed.
RESULTS: Participants highly valued peer navigator guidance to address the psychosocial complexities of a new HIV diagnosis and strengthen engagement with other support services and PLHIV community.
The PNP facilitated timely access to peer support and clinic-based appointments. The program also fostered greater appreciation among clinic staff of the practices, stories and experiences of peers working in these roles. Participants reported that these factors contributed to stronger referral pathways between clinical and community services, reducing barriers such as cost, distance and hesitancy experienced by clients.
Participants reported in-depth consultation between community and clinical partners. This included introductory meetings with clinical and peer staff and the development of formal agreements outlining organisational obligations and program scope. The PNP adapted service delivery based on assessments of client needs and service models, which required the delivery of flexible appointments available across clinical and community settings, phone and online. Ongoing knowledge transfer between peer and clinic staff was recommended for learning and improvement and to address noted challenges in maintaining referral relationships for general practices and casual medical staff.
A peer-led workplace and employment frameworks in line with GIPA/MIPA principles guided policy, process and ethical considerations that arose in the recruitment, training and supervision of peer navigators. Adequate remuneration and employee assistance, cross-support from peers, mentorship, and additional development and employment opportunities all supported peer navigators to work most effectively.
CONCLUSIONS: The PNP met an identified need in Victoria's HIV care and support sector, providing stronger continuity of care between clinical and community services. This paper uses examples of successful engagement, adaptations and supportive peer-led workplace culture and frameworks to guide the implementation of similar programs.

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