Characterization of HIV peer support based on the Dennis's peer support model - accounts from transwomen in Ghana,...

Transwomen in Ghana face significant barriers to accessing HIV prevention and care services because of marginalization and discrimination within health systems. Peer educators are increasingly used as intermediaries, yet their contributions and potential harms for transwomen in under-resourced communities remain underexplored. This study examined how peer educators support or hinder transwomen's engagement with HIV prevention and care services in urban slum communities in Ghana. In-depth qualitative interviews were conducted with 20 transwomen recruited through purposive and snowball sampling in the Greater Accra Metropolitan Area. Guided by the Dennis Peer Support Model, findings showed that peer educators provided emotional, informational, and appraisal support. Emotional support included listening, showing empathy, accompanying transwomen to HIV testing facilities, and encouraging testing. Informational support involved providing guidance on antiretroviral therapy, correcting misconceptions about HIV, and promoting healthier decisions. Appraisal support strengthened participants' sense of responsibility for HIV prevention and care through relevant information and encouragement. Overall, peer educators played an important role in facilitating access to HIV prevention and care services among transwomen in urban slums. The findings underscore the value of peer-based approaches in improving HIV-related health outcomes and supporting transwomen to live fulfilling lives while living with HIV in resource-constrained settings in Ghana.