Peer Health Navigators at Work: Vanguard for the Health Needs of Key Populations in Trinidad

These groups face significant barriers to accessing HIV services due to stigma, discrimination, and inadequate healthcare infrastructure. Peer health navigators play a crucial role in the LINKAGES approach, accompanying KPs from testing to viral suppression. These navigators, who are members of the target communities themselves, provide essential support and guidance to help individuals overcome challenges in accessing care and treatment. The peer health navigators work closely with the outreach and navigation team, which includes seven peer health navigators, three peer educators, and one social mobilizer. Challenges to KPs' use of HIV services in Trinidad include inconvenient opening hours, a lack of sensitivity among healthcare workers, and intake forms that do not accommodate gender-non-conforming categories. The community-based HIV testing and counseling services formerly provided by a nongovernmental organization ceased in January 2017, forcing the project to rely on the public health system. However, most healthcare workers in the public health system have limited training and experience in serving KPs, leading to discrimination and reluctance among KP individuals to return to public health sites. The LINKAGES approach has shown significant success in helping individuals who might otherwise remain unidentified as living with HIV and get left untreated. For the period October 2016-September 2018, approximately 753 members of KPs were tested for HIV and screened for other sexually transmitted infections. One-third of these individuals would not have been able to overcome the challenges described above without the assistance of the peer health navigators. The experience of Kevin, a gay man, and Kwasi Gill, the peer navigator who accompanied him, illustrates the success of the peer navigation approach in helping individuals achieve viral suppression. Dr. Ayanna Sebro, the technical manager of the National AIDS Coordinating Committee in Trinidad, finds the LINKAGES peer health navigators instrumental in the nation's ability to reach its HIV goals. The civil society outreach allows for the community to provide a link directly to services, as only members of the community can help reach the UNAIDS 90-90-90 targets. The LINKAGES navigators have brought a unique quality to the national response in-country, and their work is essential in developing service delivery models that can support those most affected by HIV.