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Peer- and community-led responses to HIV: A scoping review
George Ayala1,2, Laurel Sprague3, L Leigh-Ann van der Merwe4,5
1MPact Global Action for Gay Men's Health and Rights, Oakland, CA, United States of America.
Plos One
|December 1, 2021
Summary
Community-led HIV responses offer significant advantages in prevention and treatment, improving outcomes and service delivery. Evidence supports integrating these approaches to meet global AIDS epidemic goals.
Area of Science:
- Public Health
- Epidemiology
- Community Health
Background:
- Global targets aim to end the AIDS epidemic by 2030, with a focus on community-led responses.
- Current progress is insufficient, and the COVID-19 pandemic poses further challenges to achieving HIV goals.
Purpose of the Study:
- To review evidence on the comparative advantages of community-led HIV responses.
- To inform policy-making and guide efforts to achieve global HIV targets.
Main Methods:
- A scoping review of peer-reviewed literature from 1982-2020 was conducted.
- Studies included randomized controlled trials, quasi-experimental, prospective, pre/post-test evaluation, and cross-sectional designs.
- Searches followed PRISMA guidelines, using UNAIDS' definition of 'community-led'.
Main Results:
- 48 articles were selected, with most studies from the global South and involving youth.
- Community-led interventions demonstrated over 40 beneficial outcomes, including improved knowledge, adherence, and viral suppression.
- Studies reported enhanced HIV service access, quality, utilization, and retention, alongside structural improvements.
Conclusions:
- Peer- and community-led HIV responses offer a distinct advantage, particularly for prevention programs targeting key populations.
- Integration of community-led components into treatment services, informed by differentiated care, is recommended.
- Future research should focus on cost-effectiveness and synergistic effects of bundled interventions.
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