A qualitative examination of peer navigation for smoking cessation in people with HIV

People with HIV (PWH) are disproportionately affected by cigarette use, with a 40-60% prevalence rate. They achieve relatively low cessation rates following traditional interventions and often confront compounded challenges related to social factors. HIV care services have integrated Peer Navigators (PNs) into clinical care for many years, but not in the context of smoking cessation. The purpose of this study was to describe the experiences of PWH on a novel smoking cessation intervention that integrated PNs as part of a pilot randomized controlled trial.

This qualitative examination was conducted among PWH who smoke cigarettes and who participated in a randomized controlled trial between June 2020 and 2021 in Providence, Rhode Island, USA. A PN, defined as a PWH who smoked daily and successfully quit, was trained to provide cessation resources, encourage readiness to quit, and provide social support for quitting. Participants were randomized to either PN or usual care. Twenty-three participants assigned to a PN completed a semi-structured, in-depth qualitative interview. Interviews were audio-recorded, transcribed verbatim, and analyzed using thematic analysis.

Analysis revealed that participants valued the interaction with the PN and described feeling increased social support for quitting. They expressed that the use of storytelling by the PN was linked to a sense of success, and that certain traits of the PN were perceived as salient. Interacting with a PN enforced a sense of accountability, and lead to feelings of enhanced self-efficacy.

Integrating PNs to increase support for quitting seems to be highly acceptable among PWH who smoke. The findings underscore the significance of the lived experience of the peer navigator and the provision of social support.