Pivoting in the pandemic: how HIV-focused community-health workers addressed COVID-19 disparities

Abstract

Introduction The COVID-19 pandemic significantly overburdened the U.S. healthcare system and magnified pre-existing care delivery gaps in communities of color. In Miami-Dade County, Black residents account for 64% of AIDS-related deaths and experienced a COVID-19 mortality rate of 6.1%, compared to 3.9% among White residents. Community Health Worker (CHW) interventions represent a promising strategy to overcome social and economic barriers to care. Methods Leveraging a decade-long partnership with nine community-based organizations, an established CHW network originally designed for HIV outreach, was adapted to address COVID-19 disparities in high-risk minority communities. From June 2021 through May 2023, this CHW coalition incorporated COVID-19 education and vaccination support into existing outreach protocols to ensure the approach remained aligned with community values. Results During the 2-year intervention, the CHW network provided COVID-19 education regarding risk factors and vaccine safety to over 400,000 local residents. Furthermore, 8,672 individuals were screened for COVID-19, and 5,341 people were successfully referred for vaccination through these community-led efforts. Discussion Findings support engaging CHWs to deliver interventions as an adaptable strategy to improve access to care and increase uptake of resources shared about COVID-19 screening and vaccination. By being respected and well-known by their neighbors, those who work in CHW-led interventions are uniquely positioned to promote awareness and dispel myths in highly vulnerable communities. This model demonstrates the value of utilizing trusted community peers trained in healthcare navigation to bridge gaps during public health emergencies.