Peer support in healthcare services for people living with HIV. Experiences of peer support in outpatient clinics from the perspective of service users, peer supporters, and healthcare professionals

Abstract

Aims: The overall aim of this thesis was to explore peer support as a service for people living with HIV. This study aimed to describe and get an overview of peer support interventions for people living with HIV worldwide. Furthermore, how peer support was experienced by service users, peer supporters, and healthcare professionals in outpatient clinics was examined. Designs, methods, and samples: This PhD consists of three studies. Study 1 was a scoping review, where descriptive analyses and a simplified manual thematic analysis were performed to summarize the findings across the dataset. In Study 2, in-depth interviews were conducted with 16 service users living with HIV. The collected data were analyzed using directed, qualitative content analysis to organize and report the findings. Study 3 was a qualitative study involving 15 indepth individual interviews, ten peer supporters, and five healthcare professionals. In addition, two focus group discussions with 4–5 participants were conducted. An inductive approach was followed when patterns in the empirical data were identified, analyzed, and reported following a reflexive and collaborative thematic analysis. Conclusions: This thesis provides knowledge of peer support as a low threshold intervention to meet the need for social support to enhance the quality of life for people living with HIV. The project provides increased knowledge of a peer supporter's contribution to the existing outpatient clinics to respond to the multiple challenges faced by people living with HIV. The increased recognition of peer support worldwide and the supporting literature demonstrate the flexibility of peer support, adjusted to the needs of the service users. These findings indicate that peer support contributes to a more person-centered approach in outpatient clinics. Improved understanding of the providers' experiences found in this study calls for the greater availability of peer support and the development of peer support programs as a part of usual care in outpatient clinics in Norway. An increased formalization of the peer supporter role will benefit service users, peer supporters, and healthcare professionals by informing expectations. Furthermore, it seems crucial to consider the increased exchange of knowledge at outpatient clinics when incorporating people living with HIV into the development and distribution of services.