Peer Navigation Program at the John Ruedy Immunodeficiency Clinic (IDC)
Did you know that St. Paul’s Hospital has a Peer Navigation program run in partnership with Positive Living Society of BC for those newly diagnosed with HIV and people living with HIV in need emotional support or community referrals? It is the first and only program of its kind in Canada. We spoke with Glen Bradford, Manager of the Peer Navigation Program to learn more.
PHC: Tell us more about the program and how it got started.
Glen Bradford: I started with Positive Living Society in 2011 as a volunteer and was HIV positive. I wanted to work with people newly diagnosed with HIV to help them transition to life with the virus. What we discovered was people who are diagnosed with HIV are often so traumatized, that they don’t want to join a support program or even go to a HIV organization for help. So we developed a program where we can go to them and do one-on one-mentorship with clients who are newly diagnosed or who have fallen away from care treatment and support and looking for a way back in.
PHC: So how was the PHC connection made?
GB: We proposed the idea of a peer navigator office as a satellite of Positive Living clinic at the John Ruedy Immunodeficiency Clinic (IDC), at St. Paul’s in partnership with the STOP (Seek and Treat for Optimal Prevention) Project. It was an “outside the box” idea for a non-profit to have space in a clinic in a hospital but the IDC was and is very community focused and embraces the patient-centered care model. So they were willing to take a chance and have trained laypeople working along side professionals.
PHC: How did you find and choose peers?
GB: We put out a call to the HIV community and received an overwhelming response. We decided to choose those who have lived with HIV for a while, who have learned about the disease and have things to teach newly diagnosed patients. We also picked peers with a wide range of backgrounds to serve the diverse population of St. Paul’s. Right now, we have two full time staff and two part time staff at the IDC.
PHC: How Does the program work?
GB: When a new client enters the IDC, they go through an intake process (usually an interview) with an IDC nurse or social worker. Typically, a clinic peer navigator is introduced into the process immediately following this intake, which is an important step in building trust and ensuring continuity of care with the client.
The peer navigator is able to offer their lived experience right from the start, often before the client even sees a doctor. This is sometimes a new client’s first time meeting another person living with HIV. Once a new patient meets the peer navigator, they can choose whether or not to participate in this service on an ongoing basis. If they do participate, they will meet one-on-one with the peer navigator, typically shortly — within 1–2 days — after engaging with the program.
Peers will then develop ongoing relationships with clients, providing a range of services. Weekly, biweekly or monthly appointments can be made, but clients mostly drop in. The IDC in general and Peer Navigations Services in particular are set up to be low barrier, so clients do not require an appointment to see their peer navigator.
PHC: What is a typical meeting like between a client and a Peer Navigator?
GB: The Peer Navigators provide health education and break down mythology. People still have old ways of thinking imprinted in their minds about HIV. They automatically think of people dying, or sickly people walking down the street when they think of HIV. Newly infected individuals lead very different lives with modern antiretroviral medications.
They teach clients about the virus, how it affects the body, how transmission works, etc. They get clients engaged and help them understand why they are taking medications and what the medications are doing instead of just taking the medications out of fear. It empowers the patient.
PHC: What has the feedback been like?
GB: We have received lots of great feedback from the community and patients. The program has been an overwhelming success.
Clients like having the combination of a professional and an HIV+ layperson. They can get medical information from a doctor and then hear from Peer Navigators and ask questions like: “What does that mean to me in real life?,” “Is this really true?” It's a truly interdisciplinary model.
PHC: Do you see other hospitals adopting this model?
GB: We are seeing people take pieces of it and adapting it. We are in a unique situation, and so far it has not been replicated exactly. For example, in a hospital in a smaller community, there is still a lot of stigma around HIV. Those with HIV are closeted, so peers are hard to find. Even if they can find peers, newly diagnosed people wouldn’t want to be seen with them, because others will know.
Thank you Glen for sharing telling about this invaluable service to the community. If you want to have your say about stigma, check out BLOOM. To learn more about the program, please visit: http://idc.providencehealthcare.org or http://www.positivelivingbc.org
Providence Health Care President and CEO Dianne Doyle