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Peer support for people living with hepatitis B virus-A foundation for treatment expansion
Louise O Downs1,2,3, Kenneth Kabagambe4, Sarah Williams5
1KEMRI Wellcome Trust Research Programme, Kilifi, Kenya.
Insights
Peer support workers can help eliminate chronic hepatitis B (CHB) infection. Investing in peer support improves diagnosis, care retention, and interventions for hepatitis B virus (HBV) elimination.
Area of Science:
- Hepatology
- Public Health
- Health Services Research
Background:
- Chronic hepatitis B infection (CHB) affects 300 million globally, with elimination goals set by the UN and WHO.
- Peer support has improved outcomes for HIV and HCV but is underutilized for CHB.
- CHB disproportionately impacts vulnerable populations requiring targeted support.
Purpose of the Study:
- To explore the evidence and potential impact of peer support for people living with CHB.
- To advocate for the integration of peer support workers (PSWs) in CHB interventions.
- To highlight the role of PSWs in addressing the physical, psychological, and social impacts of CHB.
Main Methods:
- Literature review and synthesis of existing evidence on peer support in chronic infections.
- Analysis of the specific needs of CHB populations and how PSWs can address them.
- Discussion of requirements for scaling up peer support programs, including career pathways and cultural adaptation.
Main Results:
- Peer support can enhance education, prevention, treatment, and clinical interventions for CHB.
- PSWs can assist marginalized populations in navigating healthcare systems, reducing stigma, and improving treatment access.
- Successful implementation requires structured career paths, cultural sensitivity, and adaptable healthcare approaches.
Conclusions:
- Investment in peer support for CHB is crucial for increasing diagnosis and retention in care.
- Peer support is a vital component for designing and implementing interventions contributing to HBV elimination goals.
- Scaling up peer support requires careful planning regarding PSW training, career development, and integration into healthcare systems.
Abstract:
Chronic hepatitis B infection (CHB) affects 300 million people worldwide and is being targeted by the United Nations 2030 Sustainable Development Goals (SDGs) and the World Health Organisation (WHO), working towards elimination of hepatitis B virus (HBV) as a public health threat. In this piece, we explore the evidence and potential impact of peer support to enhance and promote interventions for people living with CHB. Peer support workers (PSWs) are those with lived experience of an infection, condition or situation who work to provide support for others, aiming to improve education, prevention, treatment and other clinical interventions and to reduce the physical, psychological and social impacts of disease. Peer support has been shown to be a valuable tool for improving health outcomes for people living with human immunodeficiency virus (HIV) and hepatitis C virus (HCV), but to date has not been widely available for communities affected by HBV. HBV disproportionately affects vulnerable and marginalised populations, who could benefit from PSWs to help them navigate complicated systems and provide advocacy, tackle stigma, improve education and representation, and optimise access to treatment and continuity of care. The scale up of peer support must provide structured and supportive career pathways for PSWs, account for social and cultural needs of different communities, adapt to differing healthcare systems and provide flexibility in approaches to care. Investment in peer support for people living with CHB could increase diagnosis, improve retention in care, and support design and roll out of interventions that can contribute to global elimination goals.
