Positive Pathways: A Peer-Driven System of Healthcare Access for People Living with HIV/AIDS
Positive Pathways (2011-2015), a collaborative initiative of Washington AIDS Partnership, Institute for Public Health Innovation, and HIV service providers across the District of Columbia and Prince George’s County, Maryland, assisted over 1,300 HIV-positive African Americans to access and effectively benefit from HIV medical care and other support services. Over 75% of Positive Pathways clients were women.
Using Trained Peers to Complement Conventional Medical and Outreach Strategies
Positive Pathways established a network of trained peer community health workers (CHWs) who were placed in clinical and non-clinical settings with the goal of identifying and supporting out-of-care HIV-positive individuals. Positive Pathways sites included AmeriHealth Caritas DC, Family & Medical Counseling Services, Whitman-Walker Health, The Women’s Collective, and Unity Health Care, among others. CHWs focused on building peer-based trust and informing individuals about living with HIV, providing personalized assistance to help them enter and navigate service systems, and supporting them throughout the early part of their medical care until they became fully engaged.
Positive Pathways evaluation results showed that 12 months after enrollment, 78% of participants had a suppressed viral load. The evaluation also showed a reduction in particular reported needs after 12 months in the program. For example, at 12 months, the percent of program participants in need of housing or shelter was cut nearly in half to 13%. Similarly, participants reported reductions in barriers to care at 12 months in comparison to enrollment. At enrollment 13% of clients cited no barriers to care, compared to 49% percent of participants and after 12 months in the program.
To learn more about how Positive Pathways built the skills and confidence of participating community health workers and how the CHWs in turn helped others, see this video: Positive Pathways Workforce Development Video.
Positive Pathways was funded by AIDS United, through a 5-year grant from the Social Innovation Fund, a federal initiative based at the Corporation for National and Community Service. Other funders provided matching funds, including Consumer Health Foundation, D.C. Department of Health, John Edward Fowler Memorial Foundation, Kaiser Permanente of the Mid-Atlantic States, M∙A∙C AIDS Fund, Morris and Gwendolyn Cafritz Foundation, and World Bank.