Peer Navigators Promote Positive Living for Key Populations with HIV

A provincial antiretroviral therapy nurse, peer educator, and MWENHO peer navigator gather after a training. Photo credit: LINKAGES/MSH

Until LINKAGES Angola developed an instrument to assess a person’s risk for contracting HIV and identify key populations, the Associação de Mulheres Vivendo com o VIH e SIDA, or MWENHO, did not have a way of indicating with certainty if they worked with key populations or not.

Through LINKAGES, MWENHO hired peer navigators—persons living with HIV who could mentor others on how to overcome the challenges of starting and adhering to treatment for HIV. The peer navigators accompanied lay counselor teams with partner organizations that provided HIV prevention and testing services in key population hot spots of Luanda Province, such as food trucks, bars, nightclubs, and brothels.

LINKAGES trained MWENHO peer navigators on how to work with key populations without prejudice. Gradually, MWENHO incorporated 14 peer navigators from key populations into its staff of 27 and encouraged them to serve as examples of positive living for their peers. The change was not just about hiring the peer navigators, but also about ensuring the organizational culture respected and valued them.

“Working with Mwenho in promoting positive living is a privilege for me,” said Joana*, a MWENHO peer navigator. “I am an agent of change, not only for others but for myself. Today I can say that I model the behavior I want to see in others. For five years I had sex with many clients without a condom even though I knew I was HIV positive. Now I always use condoms.”

Through LINKAGES, Mwenho peer navigators supported 2,173 HIV-infected people from key populations, which was essential for their initiation of antiretroviral treatment (ART) and improved quality of life. One year after LINKAGES began working with MWENHO, among the 433 HIV-infected patients peer navigators followed up with, 58 percent started on ART on the first day of consultation compared to only 24 percent who did not have the support of a peer navigator.

A year later, 67 percent of those who had started treatment remained on ART. This is thanks to the dedicated psychosocial counseling and the trust gained by MWENHO peer navigators and the HIV counselors who tested clients at the hot spots. Peer navigators and counselors maintained regular telephone contact with clients, visited them at hot spots, and sometimes at their homes as well.

As Amelia*, a female sex worker, said: “I always felt sick, but I didn’t care... [My peer navigator] convinced me and took me to the treatment program at a health facility and I finally agreed to be introduced to the MWENHO support group. I really like the group. Now I want to help my colleagues participate in the project’s programs.”

Today, national authorities and HIV patients recognize MWENHO’s patient follow-up work. In 2019 the National Institute to Fight AIDS requested technical support from LINKAGES and MWHENHO to update the Manual of Home Care for people living with HIV to include MWENHO ́s care model as an example to follow.

*Pseudonym to protect identity.

The Linkages across the Continuum of HIV Services for Key Populations Affected by HIV (LINKAGES) project, a global cooperative agreement led by FHI 360, was implemented in Angola by MSH in partnership with civil society organizations (CSOs), government stakeholders, and key population (KP) individuals, with support from the U.S. Agency for International Development (USAID) and the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR). 

The Network of Women Living with HIV (MWENHO) is an Angolan civil society organization that was created 15 years ago as a support group of women living with HIV. Its care model is based on the work of peer navigators who promote positive living. MWENHO’s mission is to promote human rights and improve medical assistance and access to medicines for women and children infected and affected by HIV and AIDS through advocacy, mobilization, and capacity-building.