What is the role of peer support in an HIV treatment and prevention setting?
Peers are everywhere, constantly providing guidance and comfort to those who are in situations they have been through themselves. This can happen anytime and anywhere. For Certified Peer Specialists (CPSs) and peer educators who work in a clinical setting, the focus shifts to mental health/substance use and prevention, but the training and principles can be applied to HIV. Mental health, substance abuse and addiction, and HIV diagnoses all come with similar challenges regarding stigma and self-image — challenges that a peer has had experience facing. Indeed, individuals living with HIV may also have a mental health/substance use diagnosis, as well. Even one of these diagnoses can be overwhelming, but when they are combined, the results can be debilitating.
Peer educators and CPSs are in a unique position to help clients understand those challenges, with the added ability to remove barriers other providers might experience, such as, “You’ve never been where I’ve been, how can you possibly understand?” They can address issues like HIV prevention through risk reduction, goal setting, self-advocacy and reliance, crisis prevention, and intervention planning, as well as listen with an understanding that their experience affords them. This relatability can pave the way to more frank discussion, fostering a trusting relationship that will help combat stigma and negative self-image and talk, which is an important step in recovery.
Jonathan L.B. Spuhler, CPS
AbsoluteCARE Medical Center & Pharmacy
How can substance abuse affect HIV in a community?
There are two sides to this question. For those who are HIV-negative, the use of substances can increase the risk of contracting HIV through high-risk sexual behavior and shared needle use. Educating these individuals about HIV and how it is spread may help them make decisions that reduce their risk, such as condom use. Addressing substance abuse through counseling and peer support can help individuals avoid high-risk behavior altogether. Referral to PrEP (Pre-Exposure Prophylaxis) services can greatly reduce their likelihood of becoming infected, but should be used in conjunction with education and counseling to help reduce the risk of contracting other STIs.
Individuals already living with HIV can harm themselves by forgetting to take their medications or make their doctor visits while under the influence. This can lead to AIDS and opportunistic infections, as well as possible resistance to medication. It can also make them more likely to infect others, a possibility compounded by the same high-risk behaviors listed above, not to mention the negative effects drugs have on the body and immune system. Counseling and education are necessary to address substance use and to stress the importance of taking HIV meds consistently. Doing so can help lower infection rates by reducing the amount of virus in a community and helping people make better decisions to lower their risk to themselves and others.