Someone Who's Sailed the Same Seas: On Peer Mentorship and HIV
When asked about the program's other successes, Bradford laughs and says: "Are you ready?"
The list is impressive for a program that's a little over three years old: more than 300 clients; nine full-time and part-time navigators who serve a diverse client population; people getting the care they need faster; more people on treatment; a satellite office for peer navigators at St. Paul's Hospital, so clients can drop in on a navigator whenever they need one; and fewer silos between clinics and community organizations like Positive Living B.C., which means that clients have better access to more services.
For clients, having a peer navigator means they have access to someone who can relate to what they are going through. Like their clients, many navigators have struggled or may still be struggling with addiction and recovery, mental illness, stigma, disclosure, homophobia and feelings of isolation or uprootedness. This allows them to empathize with clients and offer practical advice based on their lived experience. This can alleviate some of the stress of getting a diagnosis or starting treatment and makes people feel less isolated.
Having a person who can model good spiritual, emotional and physical health can make a world of difference. "My navigator was someone who was very physically and socially active," Beasley says. "It helped me to see a really healthy person sitting across from me talking about his own experience being diagnosed and navigating the healthcare system."
As a client, Beasley received one-on-one counselling and learned about the basics of HIV as well as the impact that treatment could have on his physical health. He was also connected to alternative health services -- massage, acupuncture and reiki -- to help with his emotional and spiritual health, and to social groups like Suits, a dinner group for poz gay men in Vancouver.
Peer navigator programs such as the ones in Vancouver, Regina and Kamloops are designed to strengthen the confidence and ability of clients to manage their own care. Ultimately, the goal is to improve clients' health, appointment attendance and adherence to medications.
Instead of delivering one-size-fits-all solutions, support is tailored to the needs of each client. A care plan is developed based on what the individual sees as their priorities. Navigators are there to help clients reduce the barriers that many people living with HIV face when seeking healthcare -- no barrier is too small or too large. Many people living with HIV, like Beasley, need basic information about HIV, treatment and the supports that exist in the community. Others need more intensive, long-term support -- finding housing, dealing with substance use or mental health issues. Newcomers, people who speak English as a second language and people with literacy challenges often face a plethora of linguistic and literacy barriers. In a nod to Vancouver's ethnic and linguistic diversity, Peer Navigation Services employs one peer who speaks five languages. This has reduced barriers for clients who speak English as a second language.
Bradford says that a lot of people mistrust the healthcare system: "They want their healthcare provider to give them treatment information, but they don't necessarily trust that it's going to work." That's where the navigators come in. Clients "need to hear it from someone else: 'Yes, HIV really is different now. The meds are better. You will live a longer life.'"
Though the successes and benefits are undeniable, these programs are not without their challenges. For one, they require ongoing funding and resources, and enough navigators to meet the demand. This may explain why there are so few such programs in Canada despite their benefits. Also, it can take time to build trust and foster open communication between clinicians and peers, especially in situations where a peer is also a patient of the healthcare provider with whom they are working.
Bachynski, former coordinator of the peer navigator program in Regina, can attest to that. "Some of the mentors have had conflicts with clinic staff in the past, so for both the mentor and the staff, there can be hard feelings." But Bachynski says that having navigators on-site some days to provide drop-in services for clients helps both navigators and clinicians see the navigators as professionals.
Maintaining good self-care is also a constant challenge for peers. Gloria Tremblay, an HIV-positive woman in her 70s who mentors at the Regina program, says that one of the biggest lessons she's learned in her work is that "you can't help someone if you don't take care of yourself." For Tremblay, that means spending time with family, volunteering in her daughter's French immersion class and making sure she always looks as good as she can when she leaves the house. Glen Bradford echoes Tremblay's belief that peers need to take care of themselves. "Peers give it their all to help others," he says. "They'll sacrifice their own well-being to help."
For the first while after his diagnosis, Beasley met with his navigator weekly, but, he says, "it pretty quickly became a check-in once every few weeks. And then I became a peer navigator myself." Both the Vancouver and Regina programs have seen former clients graduate to become peer navigators. "Because [my diagnosis] is pretty new for me," Beasley says, "I have a lot of empathy for others who are newly diagnosed. It's still fresh in my mind -- what it's like to get the news, what it's like to tell friends and family and people you're dating."
Although Canada's HIV navigator programs were established to help clients improve their lives, one of the unintended consequences has been that they help navigators, too. Beasley became a peer navigator to give back to a program that he says helped him immensely. But he found that in his role as navigator, the program continued to help him: "Just being able to see other people live healthily with HIV helps me on my journey of self-acceptance."
Tremblay says she gives a lot to the Peer-to-Peer Program. She pauses and then adds: "But I think I am getting even more. That's what keeps me going. I think I'm getting more than I am giving and I'm giving 150 percent."
This article was provided by Canadian AIDS Treatment Information Exchange. It is a part of the publication The Positive Side. Visit CATIE's Web site to find out more about their activities, publications and services.
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