Adapting and Scaling-up Peer Navigators to Targeted Populations of Street-Involved Youth in Kenya and Canada to Increase Engagement in HIV Prevention, Testing, and Treatment

Street-involved youth (SIY), particularly those who identify as 2-spirit, lesbian, gay, bisexual, transgender, queer, or other sexual and gender diverse identities (2SLGBTQ+), are among key populations disproportionately affected by HIV. We adapted and scaled-up a Peer Navigator intervention to targeted populations of SIY in six sites across Kenya (Eldoret, Huruma, Kitale) and Canada (London, Toronto, Vancouver), with the aim of increasing engagement in HIV prevention, testing, and treatment. This article presents the key quantitative findings, highlighting participant characteristics and their engagement in HIV testing and care before and after implementation of the Peer Navigator intervention. This implementation science study utilized a mixed-methods approach to investigate the adaptation, implementation, and evaluation of the Peer Navigator intervention. The PNs at each site completed study encounter forms with participants at enrollment and all follow ups between 2021 and 2024. Baseline sociodemographic characteristics were summarized separately using descriptive statistics for each study site. HIV testing and treatment outcomes are reported at baseline-reflecting participants' status prior to the intervention-and after their last encounter with Peer Navigators. A total of 686 SIY aged 16-29 years participated across all sites (Kenya, n = 631; Canada, n = 55). The Peer Navigator intervention improved access to and uptake of HIV prevention, testing, and treatment among SIY across Canada and Kenya. Participants' engagement in HIV testing increased from pre- to post-intervention across all sites, with the majority of participants reporting that they had been tested for HIV by the end of the study. This study highlights the need for access to ongoing and accessible HIV testing for all populations of SIY globally. The findings also underscore the critical need to create sustainable Peer Navigator roles to support SIY and expand the availability of widespread access to HIV testing.