Peer support in healthcare services for people living with HIV

Anita Øgård-Repål of the Faculty of Health and Sport Sciences has submitted her thesis entitled "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" and will defend the thesis for the PhD-degree on Friday 5 May 2023.

Øgård-Repål has attended the PhD programme in Health and Sport Sciences at the University of Agder. 

Summary of the thesis by Anita Øgård-Repål:

People living with HIV report a poorer health-related quality of life, which is linked to HIV being one of the most stigmatized diseases worldwide. Many people living with HIV become disconnected from society, impacting the social support they receive. Although peer support has been an intervention for people living with HIV since the beginning of the epidemic, peer support has become a tailored, person-centered outreach for people living with HIV taking an active role in self-management after the introduction of antiretroviral therapy. The outpatient clinics in Norway wanted to make people living with HIV equal partners and increase selfmanagement by involving peer supporters in care. Peer supporters were suggested to provide additional support to people living with HIV.

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.

This PhD consisted of three studies presented in four papers. Study 1 was a scoping review. In Study 2, interviews were conducted with service users living with HIV. Study 3 was a qualitative study involving individual interviews, with peer supporters and healthcare professionals. In addition, focus group discussions were conducted.

The thesis shows that peer support is an increasingly preferred intervention for people living with HIV in various settings worldwide, and there is extensive research on the topic. However, there is a dearth of studies regarding the experiences of receivers and peer support providers, and few studies describe the peer support interventions integrated into clinics. In addition, only a few studies were conducted in Europe, with none in the Nordic countries.

The thesis strongly suggests that a meeting between peers contributes to social support through social connectedness for people living with HIV. The service users and peer supporters developed a common-concern relationship through sharing emotions and daily living with HIV. Furthermore, the cooperation and exchange of knowledge between peer supporters and healthcare professionals at outpatient clinics indicate the potential for increased awareness for both parties. In addition, the peer support contributed to framing a dialogue between peers about different understandings of HIV and the management of a chronic lifelong condition in daily life.

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.

What to do as an online audience member:

The disputation is open to the public, but to follow the trial lecture and the public defence online, transmitted via the Zoom conferencing app, you have to register as an audience member on this Zoom link.

A Zoom-link will be returned to you. (Here are introductions for how to use Zoom: support.zoom.us if you cannot join by clicking on the link.)

We ask online audience members to join the virtual trial lecture at 10:05 at the earliest and the public defense at 12:20 at the earliest. After these times, you can leave and rejoin the meeting at any time. Further, we ask online audience members to turn off their microphone and camera and keep them turned off throughout the event. You do this at the bottom left of the image when in Zoom. We recommend you use ‘Speaker view’. You select that at the top right corner of the video window when in Zoom.

Opponent ex auditorio:

The chair invites members of the public to pose questions ex auditorio in the introduction to the public defense. Deadline is during the break between the two opponents. The person asking questions should have read the thesis. For online audience the Contact Persons e-mail are available in the chat function during the Public Defense, and questions ex auditorio can be submitted to Eli Margareth Andås on e-mail eli.andas@uia.no.