Long-acting antiretroviral treatment (LA ART) is a forthcoming option for adolescents and young people living with HIV (AYPLHIV), but perspectives on using peer mentors to implement LA ART for AYPLHIV are unknown. We conducted seven focus group discussions (n = 58 participants) from November 2021 to April 2022 in Kenya with four stakeholder groups, including AYPLHIV, healthcare providers, advocates, and policymakers. We used inductive coding and thematic analysis. Our stakeholders articulated peer mentors are crucial in the implementation of LA ART for AYPLHIV in leading communication, facilitating referrals, and providing empathy from lived experiences. Additionally, they can serve as early adopters, help navigate service points, and provide messaging on the benefits and drawbacks of LA ART. They emphasized the necessity of training peer mentors for the LA ART scale-up. Peer mentors are essential for linkage and referring of AYPLHIV to LA ART, and peer mentors' involvement should be integrated into a national implementation plan.
Keywords: Kenya; adolescents; long-acting or injectable ART; peer mentors; youth.
In the formative study “KuwaFree! LiveFree!” in western Kenya, stakeholder perspectives on the implementation of long-acting antiretroviral therapy for adolescents and young people were explored. The study focused on the role of peer mentors in this process.Aim(s) of the research—To explore stakeholder perspectives on the roles of young people who help in educating their fellow adolescents and youths, often called “peer mentors,” in implementing long-acting HIV treatment, called LA ART, as part of youth-friendly services.Background to the research—New long-acting HIV treatment, which is injected every 1 to 2 months, instead of being taken as pills by mouth every day, may alleviate some challenges faced by adolescents and young people living with HIV in keeping their HIV under control. Peer mentors may play a significant role in promoting the uptake of such new treatment among adolescents and young people.Design and methods used—We conducted focus group discussions with various stakeholders including the youth living with HIV, healthcare providers, youth advocates, and policymakers in Kenya. The discussions took place in-person or virtually, and we analyzed the recordings for important points.Patient and public involvement—Adolescents, peer mentors, healthcare providers, health advocates, and policymakers participated in the discussions.Dissemination—We held two stakeholder dissemination meetings at the study health facility, involving adolescents, peer mentors, and healthcare providers. The participants showed great enthusiasm for LA ART and engaged in an interactive question-and-answer session. Health providers concurred with the findings and discussed challenges such as managing stockouts, confidentiality concerns, and treatment failure. They also raised important questions about injection fear, medication costs, safe storage, and potential drug interactions. Other topics included the availability of LA ART for specific demographics, viral load monitoring, and cultural considerations. Dissemination strategies, such as presenting abstracts at conferences, were also discussed. The meeting provided an opportunity for stakeholders to validate focus group discussion results and raise critical questions and concerns related to LA ART.