Positive Pathways: Building a network of community health workers to complement conventional medical and outreach strategies to address HIV in the District of Columbia

Positive Pathways is an evidence-based structural intervention by the Washington AIDS Partnership which assists HIV-positive African Americans living in Washington, DC to participate in HIV medical care with a particular focus on women and their partners.

Through a network of 12 trained peer Community Health Workers (CHWs) placed in community and primary care settings in Wards 5, 6, 7 and 8, wards that have high prevalence of HIV/AIDS, Positive Pathways works to identify out-of-care individuals and support them to enter and navigate HIV medical care and service systems until they become fully engaged in their care. The model is designed with an understanding that to affect engagement in HIV care, interventions must acknowledge and help address underlying social factors, which peers are well-positioned to do through perspective transformation and building trust-based linkages to non-medical community resources.

With a comprehensive initial training program through the University of DC Community College and ongoing training and support throughout the initiative, Positive Pathways CHWs are equipped with the skills to serve on multi-disciplinary clinical and community based teams. Over the course of the first six months of implementation, CHWs have enrolled over 200 individuals into the program of which 70% are women.

Aspects of the Positive Pathways intervention can be tailored to meet the access to care and prevention needs of diverse demographic groups and communities and to address various diseases that are prevalent in communities with the least access to healthcare.