A Peer Driven System of Health Care Access for People Living with HIV
Positive Pathways was a five-year initiative of the Washington AIDS Partnership, in collaboration with the Institute for Public Health Innovation. It improved access to HIV care for low-income African Americans living in Washington, D.C. and Prince George’s County, MD.
Using Trained Peers to Complement Conventional Medical and Outreach Strategies
Positive Pathways established a network of trained peer Community Health Workers (CHWs) who were placed in community, managed care, and primary care settings with the goal of identifying out-of-care HIV-positive individuals. CHWs focused on building peer-based trust and informing individuals about living with HIV, providing personalized assistance to help them enter and navigate service systems, and supporting them throughout the early part of their medical care until they become fully engaged.
Peer CHWs utilized their unique position to address barriers to care that can present challenges for other medical professionals, such as providing trust-based information and education, overcoming denial and stigma, conducting outreach and support deep in the community, taking the time to walk clients through the health care system, and helping clients strategize to manage the logistics of caring for oneself in the context of a complicated life.
Working in Communities with the Highest Need
CHWs hired through the initiative were placed at community, managed care, and medical care providers in D.C., where at 2.5% of residents are living with HIV, and Prince George’s County, MD, the second epicenter of the region’s HIV epidemic. Host sites included AmeriHealth Caritas District of Columbia, Family & Medical Counseling Service, Heart to Hand, HIPS, Institute for Public Health Innovation, Unity Health Care, Whitman-Walker Health, and the Women’s Collective.
High Impact in the Local Community
In its five years (2011-15), Positive Pathways reached more than 1,600 individuals, providing access to care services, and linked almost 1,300 individuals to medical care.
A Partnership for Success
Positive Pathways included a variety of partners: the Institute for Public Health Innovation; CHW sites listed above; D.C. Department of Health’s HIV/AIDS, Hepatitis, STD, and TB Administration; and the District of Columbia Primary Care Association. The initiative was funded through the AIDS United Access to Care Initiative, supported by a grant from the Social Innovation Fund. During the five-year initiative, other funders included AmeriHealth Caritas District of Columbia; Bristol-Myers Squibb; Morris and Gwendolyn Cafritz Foundation; Consumer Health Foundation; John Edward Fowler Memorial Foundation; D.C. Department of Health’s HIV/AIDS, Hepatitis, STD, and TB Administration; Kaiser Permanente of the Mid-Atlantic States; M∙A∙C AIDS Fund; Magic Johnson Foundation; and the World Bank Group.