Understanding the implementation of patient navigation for adults living with HIV: A scoping review of components, equity considerations and lessons learned.

BACKGROUND

People living with HIV navigate complex medical and social challenges that impact engagement in care, including stigma, poverty and systemic inequities. Patient navigation has emerged as a promising approach to improve linkage, retention and adherence across the HIV care continuum. While evidence suggests that navigation enhances care engagement and health outcomes, little is known about how these programs are implemented in real-world settings, particularly with respect to equity.

AIM: This scoping review mapped the literature on the implementation of HIV patient navigation programs, with attention to program components, barriers, facilitators and equity considerations.

METHODS

Following the Joanna Briggs Institute framework and PRISMA-ScR guidelines, we searched six databases (MEDLINE, Embase, PsycINFO, JBI, Scopus, Web of Science) and identified 31 eligible studies (2000-2025). Data extraction and synthesis were guided by the Consolidated Framework for Implementation Research (CFIR) and PROGRESS-Plus.

RESULTS

Most programs were based in the United States, with others in Africa and Latin America. Navigation was delivered by professionals (35%), peers (35%), or both, with interventions spanning 6-12 months and often including psychosocial support, care coordination and linkage to social services. Facilitators included navigator accessibility, cultural responsiveness and organizational support, while barriers involved system fragmentation, limited funding and structural inequities. Few studies explicitly operationalized equity within implementation strategies.

DISCUSSION: Navigation programs were associated with improvements in ART adherence, care engagement and psychosocial well-being. Findings underscore the importance of embedding equity frameworks into navigation design to ensure sustainable, person-centered models of HIV care that address the needs of marginalized populations.