What is the program?
The SafeLink Alberta HIV peer support and navigation program connects people living with HIV with peer support groups and/or peer navigation services. The peer support groups provide a non-judgmental, safe and inclusive space for people living with HIV to get together in a social setting. Peer navigators use their own experience living with HIV to promote wellness and provide one-to-one emotional support.
SafeLink Alberta works to reduce the risks associated with sexual activity and substance use by providing education, non-judgmental services and harm reduction programming in Calgary and southern Alberta. The program is funded by Alberta Health.
Why was the program developed?
SafeLink Alberta was formerly known as AIDS Calgary. It started in 1983 when a group of concerned citizens gathered to advocate for the gay community and support those being diagnosed with HIV/AIDS. The organization was volunteer led and peer driven for many years, and peer support work remains critically important to the success of the organization’s programs.
The HIV peer support and navigation program was developed as a way to provide support to people living with HIV. Peer support is seen as a best-practice model for supporting people who have been diagnosed with HIV and can be one of the most significant tools a person can use on their journey.
Peers were instrumental in the development of the program, as was listening to the community of people living with HIV, finding out what they want and how the program can work.
How does the program work?
The HIV peer support and navigation program offers support in the form of peer support groups, as well as one-to-one peer navigation services.
The program is staffed by peer navigators who provide systems navigation (e.g., linkage to health and wellness resources), support group facilitation, advocacy, education and emotional support relevant to people living with HIV. Peer navigators are individuals living with HIV who are willing and able to draw upon their personal experience to support others, work within the community with transparency about their HIV status, collaborate with health and social service professionals and provide individualized emotional support and service navigation in both one-on-one and group settings. The support provided by peer navigators is non-judgmental and its goal is to increase a client’s understanding of HIV so that they can make informed decisions about their own treatment and care.
The program is overseen by a program manager who supports the peer navigators, collaborates with them to make program improvements and helps with system navigation. The program manager provides structure, accountability and expectations for the program and is responsible for collecting data and reporting back to the funder. Through collaboration and shared decision-making, the program manager and peer navigators are able to make continual adjustments and improvements to the program.
An HIV/hepatitis C case manager also supports and collaborates with the peer navigators. The peer navigators and HIV/hepatitis C case manager can make referrals to each other and share information about available resources for clients. They may also talk through challenging situations that arise for the peer navigators (with appropriate consent from clients).
People find out about the program through word of mouth, through other programs at SafeLink Alberta and through outside agencies such as the Centre for Newcomers or the sexually transmitted infection (STI) clinic.
Peer navigators complete an intake and assessment process when clients first join the program. This includes identifying the person’s treatment and service goals and whether they would like to join a peer support group or access one-to-one peer navigation support (or both).
Peer support groups
Peer support groups provide people with HIV a place to share what they are going through, ask questions, receive support and encouragement, and create a new social circle of individuals who have similar experiences. Support groups are peer led. They can be in person or online (via Zoom) and are offered monthly. The meeting time and location is kept consistent each month, but the meeting location is not shared publicly for the safety of participants because of the stigma and discrimination around HIV in the community.
The group uses confidentiality statements and group guidelines to guide both in-person and online meetings. Group meetings are confidential: attendees are asked not to share who is at meetings or what is discussed. Similarly, anything shared in a group chat in an online Zoom meeting is immediately deleted following the meeting. Group guidelines request that attendees introduce themselves when they first attend a meeting and then limit sharing to three to five minutes to give everyone an opportunity to share. Side conversations, as well as the use of phones during meetings, are discouraged and attendees are asked to use the mute function in Zoom when they are not speaking. Tips on how to keep yourself anonymous in Zoom are also provided (e.g., disable recording, screen sharing). More information on conducting Zoom meetings for this clientele is available in the Program materials section.
Groups range in size from four to 15 people and topics are typically determined by the peer support group leaders and group participants. Guest speakers are invited to attend meetings and present on topics that are relevant to living with HIV (e.g., aging with HIV, nutrition). Examples of topics covered in peer support groups include:
- mental health (e.g., depression, anger management)
- HIV disclosure, stigma and language
- HIV medication (e.g., changing medications, skipping or stopping medications, new medications, medication side effects)
- sharing life stories
- exercise, substance use and healthy living
- supports for people living with HIV and support systems
- safer sex topics
Three groups are currently available:
- Plus Friends is for male-identifying participants. Clients can invite their partners to the group every other month.
- Positive Connections is for female-identifying participants. The group consists primarily of individuals who are members of African, Caribbean and Black (ACB) communities.
- Parejas Unidas is a group for people who speak Spanish as their first language. Partners can also attend all meetings.
In addition to formal peer support groups, social events are organized throughout the month (e.g., monthly coffees, BBQs, social walks) to provide informal opportunities for people to meet each other and connect.
Peer navigation (one-to-one support)
Clients can connect to peer navigators on a one-to-one basis outside of support groups. One-to-one peer navigation is flexible and person centred, and the supports provided are determined in partnership with the client and the peer navigator. Clients are normally paired with a peer navigator of the same gender, but pairing can also be based on language preference (e.g., if the peer navigator speaks the same language as the client), as well as overall fit and comfort.
Peer navigators are available to provide:
- client-centred support and risk reduction counselling
- individualized education and information on HIV treatment and strategies for healthy living
- translation services
- accompaniment to appointments
- system navigation based on the peer navigator’s personal experience/knowledge of these systems; peer navigators can support clients to find solutions to access challenges, as they have knowledge of whom to contact and where to access services
- referrals to human services (e.g., justice, income, employment, parenting)
- support for individual capacity-building goals (e.g., education, employment, financial)
The frequency with which peer navigators and clients are in contact with each other depends on the client’s needs. Some peer navigators and clients are in contact on a daily or weekly basis; others connect once or twice per month. There is flexibility. For example, clients who are new to Canada may receive peer navigation services on a weekly basis to start as they are becoming familiar with services and then transition to less frequent contact as they establish their network of care.
Peer navigation supports are available for as long as clients need them. Clients can also reconnect with peer navigators after a period of non-contact. Clients can shift from one-to-one peer navigation support to only attending a monthly support group, and vice versa, depending on their needs.
Navigation can be done via phone calls, via Zoom chats and in person. The in-person meetings happen within the community (e.g., coffee shops) or at the Southern Alberta Clinic (SAC), an outpatient clinic for people living with HIV. SafeLink Alberta and SAC have a formal partnership and the program’s HIV/hepatitis C case manager attends monthly case conferences and reports relevant information to the HIV peer support and navigation team as necessary. Peer navigators can also attend SAC appointments with clients. Peer navigators and clients are provided with bus tickets if needed to get to appointments or to meetings with each other.
Peer navigator recruitment, hiring and training
Peer navigator positions are posted publicly and candidates submit resumes and are interviewed. They are employed casually (maximum of 20 hours per week) and make their own schedules. The salary range for the position is $20.00 – $25.00 per hour. New peer navigators are often recruited via word of mouth through current peer navigators. Representation of different ethnicities and gender identities is important among peer navigators, as well as knowledge about HIV and an interest in ongoing learning. The peer navigators need to have some flexibility to be available to support navigation during business hours (Monday–Friday, 8 am – 4 pm).
As staff of SafeLink Alberta, peer navigators are expected to attend a variety of agency trainings over the course of their first year of employment, including the following:
- HIV 101: Transmission, Prevention, and Treatment Cascade
- HCV & STI’s 101
- Harm Reduction 101: Sex, Drugs, and Human Rights
- Substance Use 101: Substances, Safety, and Support
- Universal Precautions 101: Best Practices in Protection Against Blood Borne Pathogens
- Safer Substance Use Practices 101: Safely Equip Before Taking a Hit
- Sex Work 101: Shifting Perspectives
- Safer Sex Supplies 101
- Naloxone Training
Peer navigators are expected to keep on top of trends and news related to HIV; the program manager plays a role in sharing relevant information with them as it becomes available.
Peer navigators are also required to have the following:
- criminal record check with vulnerable sector (a criminal record will not necessarily preclude a candidate from being hired; decisions are made on an individual basis and all information is kept confidential)
- suicide intervention training and trauma-informed care training
They are paid to attend any trainings, and training can also take place outside of SafeLink Alberta (e.g., peerconnectbc.ca, CATIE).
- Peer navigators
- Program manager
- HIV/hepatitis C case manager
- Space for monthly support group meetings and one-to-one meetings
- Zoom licence for online meetings
- Bus tickets or tokens
Data related to each of the three support groups collected between November 2021 and September 2022 shows that:
- attendance at the Plus Friends group ranged from five to 18 people per month, with zero to three new attendees per month
- attendance at the Positive Connections group ranged from two to five people per month, all of whom were repeat attendees
- attendance at the Parejas Unidas group ranged from five to nine people per month (the group started in January 2022), with zero to three new attendees per month
Limited information is collected on the one-to-one peer navigation sessions because of the confidential nature of the interactions. Information collected includes number of sessions, unique contacts and contact minutes between peer navigators and clients. Between November 2021 and September 2022 there were:
- over 550 one-to-one sessions between peer navigators and clients
- between 20 (June 2022) and 31 (September 2022) unique contacts between peer navigators and clients per month (i.e., 20 to 31 clients were connected to a peer navigator per month)
- between 2,820 (November 2021) and 3,750 (September 2022) total contact minutes per month between peer navigators and clients
- Hiring/recruiting new peer navigators can be challenging. Some people are not open to everyone about their HIV status. There is still a lot of stigma and discrimination associated with living with HIV in the community.
- Building a relationship based on trust between the peer navigator and the program manager can be a challenge as there is a lot of autonomy in the role (e.g., peer navigators make their own hours, often work outside of traditional business hours and work independently).
- Funding for, and therefore the capacity of, the program can be a challenge, and sometimes activities have to be capped as staff time can be limited by funding availability.
- The peer navigators were instrumental in the development and ongoing evolution of the program, and the program manager and peer navigators must work in partnership to make decisions related to the program.
- Listening to the community of people living with HIV and finding out what they want and how the program can work with them is essential. The program is constantly evolving and service providers need to adapt and be willing to change how services are offered.
- The program is based on human relationships that take time to build. The dynamic of these relationships can change when new people are added. Building and maintaining relationships, as well as taking the time to foster strong relationships (e.g., reply time to emails, text messages, remember people’s names) is essential.
- Approaching the work with empathy and compassion and striving to earn and honour trust is important.
- Collaboration and communication are the foundation of the program; they are the reason why the peer program has seen growth.
Monika Kiegelmann, BAAJS (she/her)
Manager, Calgary Support Services
SafeLink Alberta (formerly HIV Community Link)
1944 10 Ave SW Calgary, AB. T3C 0J8
Phone: (403) 850-7700 (direct)