Maithe Enriquez, an associate professor of nursing, is trying to help HIV-positive patients to better follow their treatment plans.
Peers Keep It Real, a program Enriquez built around HIV-positive peer educators, helps patients overcome the barriers that prevent them from adhering to their HIV treatment.
Enriquez said in her years as a nurse, she’s seen too many people die from the virus just because they didn’t adhere to the proper treatment.
“When you see that, at least for me, it’s like, what can I do to help folks?” Enriquez said.
The reasons patients do not adhere to their HIV treatments — which often consist of taking just one pill a day — vary, Enriquez said.
Enriquez said an HIV diagnosis sometimes leads patients to a state of depression causing them to ignore their treatment regimen. She also said that for patients in situations of poverty without ready access to care, treatment often is not their first priority.
“They’re more worried about getting a meal or finding a place to sleep than taking their medicine,” Enriquez said.
But Enriquez said the biggest obstacle in getting patients to follow their treatment regimen is the stigma surrounding HIV, especially in communities of color.
“The stigma that surrounds the disease has not gone away,” Enriquez said. “People assumed the only way you got this disease was by doing horrible things.”
And the stigma is not limited to the general public, Enriquez said. She said she remembers an instance where health care providers misdiagnosed a healthy-looking man because they believed he did not look like a person with HIV.
Enriquez started Peers Keep It Real at the Truman Medical Center in Kansas City to deal with these issues.
The program matches an HIV-positive patient with an HIV-positive peer. In six one-hour sessions over six weeks, with one follow-up session at 12 weeks, the peer helps the patient identify barriers that prevent him from adhering to his treatment. The peer works with him to create strategies to overcome those issues.
Deana Hayes is a peer educator who was diagnosed with HIV at age 35 and began working with Peers Keep It Real three years ago.
“They will share with me kind of more personal (issues) than they will with their provider,” Hayes said. “They feel like I kind of understand.”
Hayes said she’s been in their position.
“Everybody’s story is different,” Hayes said, “but I personally know the feeling.”
While 14 of the 15 peer educators are paid, it is Hayes’ full-time job. Peer educators are not health care professionals. They do not have formal medical training. Enriquez said they receive about six months of training in behavioral science, therapeutic relationships and facilitating interventions.
Hayes said the program is an impactful experience not just for the non-adherent patients, but for her as well.
“It’s definitely changed my life,” Hayes said. “I give hope daily to people.”
Enriquez said when patients adhere to their treatment, they lower their viremia, or the amount of HIV in their blood, enough to reduce their risk of spreading the disease by 96 percent.
“If we could get everyone (with) HIV on treatment, we could stop this disease,” Enriquez said.
Peers Keep It Real recently received a grant from the National Institutes of Health to expand the program to all of Kansas City.
“It helps us to continue on to help other people — to give them a future, to keep us going,” Hayes said. “It makes you feel like someone recognizes and acknowledges that peers are very important in the medical health field.”
And if peer educators continue to identify with HIV patients on a personal level to create strategies for treatment adherence, Enriquez said the victories might just keep on coming.
“It sounds really simple,” Enriquez said. “And it kind of is.”