Becoming a Buddy: Accordance and Incompatibility in the Hepatitis C Peer Support Role

Author: Bonnington O & Harris M

Theme: Social Science & Policy Research Year: 2016

BECOMING A BUDDY: ACCORDANCE AND INCOMPATABILITY IN THE HEPATITIS C PEER SUPPORT ROLE Bonnington O 1 & Harris M 1 1 London School of Hygiene & Tropical Medicine Background: Peer support has become an important element of healthcare delivery in relation to blood borne viruses in recent years. However, the parameters of the peer role in respect of people who inject drugs (PWID) at risk of or diagnosed with hepatitis c (HCV) are not well established. To understand where tensions and congruities lie with the role, and to inform better HCV peer support policies and practices, there is a need to establish what a peer is in the context of its key relations. Methods: Qualitative research was conducted as part of a wider study exploring the effectiveness of a complex intervention – including a peer support service – in two specialist UK drug treatment clinics, aimed at increasing HCV diagnosis and treatment. Four focus groups and nine interviews with PWID, and two focus groups and nine interviews with drug services and intervention providers were conducted, transcribed and analysed thematically. Results: As a decontextualised psychological entity, considerable commonality across the sample saw the peer constructed as empathetic, trustworthy, nonhierarchical, self-confident, accepting, proactive, and able to draw upon their experience/knowledge of HCV or drug addiction. In practice, however, the peer became fragmented. Organisational structures restricted who could become a peer, and governmental rationalisation foreclosed nuances in the role’s performance, reducing peers to functional resources, which limited the emergence of trust within peer-user relationships. A priori delineations of role functions – and peers’ internalisation of these – created tensions in role-relations, especially as PWID preferred to relate to peers on more personal terms. A further tension included the framing of peers as workers versus volunteers. Conclusion: Embedded within relations, practices and policies, peers become multiple, such that claims on what they should be are somewhat incompatible. When initiating peer-led programs, acknowledging different stakeholder perspectives on what a peer is will be key for successful interventions. Disclosure of Interest Statement: The study this paper draws on is funded by the UK Department of Health [PR-R5-0912-13001]. M. Harris has received honorarium for presenting research findings at Gilead and AbbVie sponsored meetings.

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