Abstract:
Improving patient engagement in HIV care is critical for maximizing the impact of antiretroviral
therapy (ART). We conducted a systematic review of studies that used HIV-positive peers to
bolster linkage, retention, and/or adherence to ART. We searched articles published and indexed in
Pubmed, PsycINFO, and CINAHL between 1996–2014. Peers were required to be HIV-positive.
Studies were restricted to those published in English. Nine studies with n=4,658 participants met
the inclusion criteria. Peer-based interventions were predominantly focused on improving
adherence to ART, or evaluations of retention and adherence via viral suppression. Five (56%)
were conducted in sub-Saharan Africa. Overall findings were mixed on the impact of peers on
ART adherence, viral suppression, and mortality. While positive effects of peer interventions on
improving linkage and retention were found, there were limited studies assessing these outcomes.
Additional research is warranted to demonstrate the impact of peers on linkage and retention in
diverse populations.
