Peer-supported digital collection of patient-reported outcomes in HIV care: Promise, practical barriers and lessons from a pilot study within the ICONA cohort.

PURPOSE: To explore whether peer support could enhance patient-reported outcome (PRO) completion through a mobile health platform within the ICONA cohort of people with HIV in Italy, and to identify practical lessons for integrating peers into digital, person-centred HIV care.

MATERIALS AND

METHODS

A pilot intervention was implemented in four cohort centres where trained peers, affiliated with the ICONA Community Advisory Board, supported PRO completion using the e-QoL mobile app over a five-month period. Fourteen additional centres without peer involvement served as comparisons. The primary outcome was the proportion of people with HIV fully completing ≥1 PRO before and during the intervention. A Difference-in-Difference (DiD) model, adjusted for demographic, HIV-related and socioeconomic variables, estimated the effect of the peer intervention.

RESULTS

During the intervention, 2421 people with HIV were followed in peer-supported centres and 2640 in peer-free centres. PRO completion increased from 1.24% to 3.08% in peer-supported sites, while a slight decline was observed in comparison centres (0.97% to 0.83%). The adjusted DiD analysis indicated a 2.0% absolute increase (95% CI: -0.40 to 4.5) attributable to peer support. Respondents were predominantly cisgender Italian men with higher education, suggesting limited reach to more digitally or socially vulnerable groups.

CONCLUSION

Peer support modestly improved PRO completion and fostered greater awareness of PROs within HIV care.