February 23, 2024

The PNP study

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 has been following the implementation peer navigators in all the study sites since 2019. All peer navigators are between the ages of 18-29 and have a diversity of life experiences and identities. To better support youth in the Toronto and Vancouver sites, the peer navigators also identify as 2SLGBTQ. Peers provide a range of supports for youth who are connected to the street, including but not limited to:

List that describes the range of peer navigator activities

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 and/or lesbian, gay, bisexual, transgender, queer (LGBTQ2S), or 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, 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 2024. Peer Navigators are young adults between the ages of 18 and 29 years. In Toronto and Vancouver, they also identify as 2SLGBTQ. The Peer Navigators are full-time, paid employees at host organizations that are seeking to better engage street-connected youth with HIV care. Following a mixed method 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 is monitoring the Peer Navigator’s progress in engaging street-connected youth in care. Encounter forms collect baseline data and then monitor changes to the youth’s health and housing status. Mixed-method evaluations use surveys and key informant interviews with street-connected youth, community stakeholders, and healthcare providers in assessing the ongoing impact of the programming in each of the sites.