
A three-year cohort study titled “Peer support for people living with hepatitis B virus - A foundation for treatment expansion,” has demonstrated the transformative impact of Peer Support Workers (PSWs) in improving treatment adherence among patients with Hepatitis B virus (HBV). Published in the Journal of Viral Hepatitis, the study highlights how PSWs, trained individuals with lived experience of a condition, helped increase awareness, reduce stigma, and enhance retention in care.
Conducted within the Unit’s 24,000-strong General Population Cohort in southwestern Uganda and funded by Wellcome Trust, the study assessed the role of PSWs in supporting patients on nucleos(t)ide analogues (NAs), a proven but underutilized HBV treatment due to late diagnosis, low adherence, and irregular healthcare visits.
Study findings
In the first phase, a randomised controlled trial (RCT) compared patients receiving PSW support with those in standard care. PSWs provided culturally tailored education, emotional support, and healthcare navigation guidance. The results showed that patients with PSW support had 60.9% higher treatment adherence, 40% greater likelihood of remaining in care, 51% reduction in irregular health facility visits and 58% reduction in stigma-related barriers.
Building on these findings, the second phase involved community-based surveys to explore patient perspectives. Insights revealed that PSWs provided more than just clinical support. Patients valued their emotional and social guidance, which helped overcome stigma and foster confidence in managing their condition.
"Before meeting my peer support worker, I was afraid to even pick up my medication because I thought people would judge me. But through our group conversations, I learned that my health comes first. Now, I take my medicine every day without fear, and I even encourage others to do the same," said Charles Sekitto[1] , a study participant.
A model for strengthening healthcare systems
The study demonstrated that integrating PSWs into healthcare teams enhances patient trust, engagement, and access to treatment.
"Peer support is more than just assistance, it’s a lifeline. Our findings show that PSWs can reduce barriers to care, foster trust, and empower patients to take control of their health," said Professor Louise Downs, Chief Investigator from KEMRI-Wellcome Trust.
Professor Robert Newton, Principal Investigator and Head of Oncogenic Virus Immunovirology at the Unit, emphasised:
"Investing in peer support not only improves individual lives but also strengthens healthcare systems and advances public health. There is need to integrate PSWs into routine care for sustainable impact.”
These findings support efforts to expand community-driven healthcare models, particularly for Hepatitis B and other chronic conditions, reinforcing the importance of patient-centered interventions in public health.
This study is located in the Unit’s viral pathogens research theme. Learn more about viral pathogens research at the Unit.
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