The Peer Navigators Project is a collaborative research project, that brings together researchers and community partners in Canada (Toronto, Vancouver, and London) and Kenya (Eldoret/Huruma and Kitale) to explore and evaluate the use of peer supports supports for street-connected youth’s access to HIV and AIDS prevention, testing and treatment.
The study followed peer navigators in all the study sites from 2019 to 2024. The peer navigators were between the ages of 18-29 and had a diversity of life experiences and identities. To better support youth in the Toronto and Vancouver sites, the peer navigators also identified as 2SLGBTQ+. Peers provided a diverse range of supports for youth who are connected to the street, including but not limited to:
Background
In Canada, about 1/3 of people diagnosed with HIV are youth. In Kenya, young people between the ages of 15 and 24 living with HIV constitute 15% of the total 1.5 million people living with HIV and AIDS in the country and make up almost half of new HIV diagnoses annually. Street-connected youth and youth experiencing housing insecurity are at heightened risk of acquiring HIV as a result of injection drug use, polysubstance use, transactional and/or commercial sex, sexual violence, and trafficking. Despite recent advances in HIV and AIDS prevention and treatment, there is a dearth of knowledge about the services tailored towards populations of street-connected youth, especially those who live in smaller cities, identify as Two-Spirited, lesbian, gay, bisexual, transgender, and queer (LGBTQ2S+), and live in low- and middle-income countries.
Importance of the study
Social and economic inequities lie at the heart of the HIV epidemic globally. Poverty, sex and gender disparities, homophobia, transphobia, racism and other structural inequalities can result in addictions, homelessness, family violence, and violence against women and children more broadly. With nowhere else to go, children and youth migrate to streets all over the world as a mechanism to survive and to seek alternatives to what they are leaving. The primary pathways into homelessness for young people globally overlap with key determinants of HIV risk and there continue to be well-documented HIV and hepatitis C epidemics among street-connected youth who inject drugs in Vancouver, Toronto, and elsewhere in North America.
Methodology
The study is funded by the Canadian Institutes for Health Research (CIHR). It started in 2018 and will run until 2027. The Peer Navigators were full-time, paid employees at host organizations that sought to better engage street-connected youth with HIV care. Following a mixed-methods design, Phase I of the study used a quantitative survey, qualitative focus groups, key informant semi-structured interviews and theatre testing to assess the acceptability and appropriateness of the PN intervention with the targeted populations in the different study sites. Phase II of the study monitored the Peer Navigator’s progress at engaging street-connected youth with care. Encounter forms collected baseline data and then monitored changes to the youth’s health and housing status. Mixed-method evaluations used surveys and key informant interviews with street-connected youth, community stakeholders, and healthcare providers to assess the ongoing impact of the programming in each of the sites.
Now that data collection is complete, the team is focused on knowledge translation and mobilization. Findings have been disseminated through multiple peer-reviewed publications (see News & Publications page) and conference presentations on HIV and AIDS, homelessness, and health, including International AIDS Society (IAS), Canadian Conference on HIV/AIDS Research (CAHR), and Community Health Nurses of Canada (CHNC). In Spring 2026, we plan to convene a stakeholder meeting in Eldoret, Kenya. Many of the Peer Navigators involved in the project continue their work with our community partners or in related fields supporting marginalized communities’ access to lifesaving services and healthcare.