Exploring Non-Governmental Organisation Delivered Peer-Led HIV Services and Interventions in England: A Critical Review

<p dir="ltr">A thesis submitted in partial fulfilment of the requirements of the University of Lincoln for the degree of Doctor of Philosophy by Practice Portfolio in Health and Social Care.</p><p dir="ltr"><b>Thesis Summary:</b> This thesis comprises a portfolio of work and a critical review. It presents three interconnected studies linked through their exclusive focus on utilising peer-led services and interventions in the field of Human Immunodeficiency Virus (HIV) medicine. The thesis focuses on two evaluations of peer-led services for adults living with HIV, and one peer-led intervention that supported knowledge diffusion of, and increased uptake of, an HIV prevention medicine (Pre-Exposure Prophylaxis or PrEP) for adults in England.</p><p dir="ltr"><b>Thesis Aims:</b> The studies presented in the accompanying portfolio seek to explore the current impact of non-governmental organisation delivered, peer-led services and interventions, both in supporting adults living with HIV, and in the prevention of HIV in adults in England.</p><p dir="ltr"><b>Thesis Objectives:</b></p><ol><li>To document examples of peer-led services and interventions in the care, management, and prevention of HIV in adults, delivered by non-governmental organisations in England.</li><li>To describe the design and delivery of those services and interventions.</li><li>To explore the impact of those services and studies on service users, service staff, and (where relevant) the National Health Service (NHS).</li><li>To provide evidence of the need for non-governmental organisation-delivered peer-led HIV services and interventions in England.</li><li>To reflect on the achievements and learning arising from independent evaluation of the services and interventions.</li></ol><p dir="ltr"><b>Contribution to Knowledge:</b><b> </b>The portfolio contributes to knowledge, practice, and policy by demonstrating the impact that adult-focused peer-led services and interventions in England, contribute to improving the wellbeing of people living with HIV, and in diffusing knowledge about HIV PrEP, to people who are least likely to know about it. Additionally, the portfolio of work demonstrates that peer support may help to reduce the impact of social determinants of health and social inequalities faced by people living with HIV, particularly those belonging to marginalised groups. Furthermore, this thesis presents two original implementation frameworks, designed by the candidate for inclusion in this thesis, which support the future development and delivery of peer-led HIV services and interventions for adults in England.</p>