Peer navigation to support psychosocial well-being and HIV treatment among adolescents: A rapid review

Abstract

Background: Adolescents living with HIV (ALHIV) in sub-Saharan Africa experience poorer outcomes across the HIV care cascade than other age groups because of intersecting developmental, psychosocial and structural barriers. Peer navigation has emerged as a promising strategy to support engagement in care, yet evidence on its effectiveness and implementation for ALHIV remains fragmented.
Aim: To synthesise evidence on peer navigation and peer-led psychosocial support interventions for adolescents living with HIV.
Method: A rapid review was conducted in accordance with PRISMA 2020 principles. PubMed and EBSCOhost databases were searched for qualitative, quantitative and mixed-methods studies published between 2013 and 2025.
Results: Fourteen studies conducted across eight countries were included. Peer navigation interventions were typically delivered by young adults living with HIV who were stable on treatment and trained to provide psychosocial, adherence and health system navigation support. Most studies reported improvements in antiretroviral therapy adherence, retention in care and viral suppression, although effects varied by context and were not always sustained. Psychosocial benefits included reduced stigma, strengthened trust and improved self-efficacy. Implementation findings indicated high acceptability and feasibility, supported by structured training and supervision, alongside challenges related to sustainability and structural barriers such as transportation costs.
Conclusion: Peer navigation is a valuable component of adolescent-friendly HIV care in sub-Saharan Africa, particularly when integrated within responsive clinical systems and complemented by strategies addressing structural vulnerability.
Contribution: This review consolidates regional evidence on peer navigation for ALHIV and provides implementation-relevant insights to inform the integration and scale-up of peer-led models within public sector HIV services.