Category: General

What Happens When HIV Programs Drop the Word “Peer”


Sometimes the most revealing decisions in public health come down to a single word.

Across the country, addiction recovery programs openly hire Peer Recovery Coaches and Peer Support Specialists, recognizing that lived experience is a powerful tool in helping others navigate recovery. Yet in some HIV programs, similar roles appear under more neutral titles such as Linkage to Care Specialist or Treatment Adherence Specialist.

The work may look similar. The message to the community is not.

The concept of peer support did not originate in HIV programs.

Modern peer roles trace their roots to the psychiatric survivor and mental health consumer movements of the 1970s and 1980s, when people with lived experience of mental illness began supporting one another outside traditional clinical systems. Those efforts later became formalized as Peer Support Specialists within behavioral health systems.

The model expanded further in addiction recovery, where Peer Recovery Coaches and Recovery Support Specialists are now widely recognized roles built on lived experience with substance use and recovery. The Substance Abuse and Mental Health Services Administration (SAMHSA) recognizes peer support as an evidence-based component of behavioral health systems.

Only more recently has the model been adopted in HIV care. Peer navigators and peer educators have been shown to improve engagement in care, treatment adherence, and retention among people living with HIV. The Health Resources and Services Administration (HRSA), which oversees the Ryan White HIV/AIDS Program, has highlighted peer navigation as a promising strategy for strengthening the HIV care continuum.

That history matters because peer support was never simply a staffing model. It was a philosophy that recognized lived experience as a form of expertise.

What distinguishes peer roles is not just the tasks they perform, but the intentional use of lived experience as part of the intervention itself.

That is why language matters.

In addiction recovery programs across the country, the word peer appears openly in job titles. Yet in some HIV programs, similar roles are introduced under more neutral titles that existed long before peer navigation models were adopted.

The explanation often offered is practical. Human resources departments sometimes worry that including the word peer could imply hiring based on HIV status.

But other fields have already found ways to recognize lived experience while still operating within standard hiring frameworks, often through training and certification models.

If addiction recovery systems can openly recognize lived experience in job titles, it raises a fair question: why does HIV work sometimes hesitate to do the same?

Part of the answer may be institutional culture. Large organizations often gravitate toward language that feels more neutral or professionalized.

Part of it may also reflect something more specific to our region. HIV stigma still runs deep in many Midwestern communities. Even as treatment has transformed HIV into a manageable condition, the social discomfort around the virus has not disappeared.

As HIV navigation programs continue to grow in Indianapolis, this may be a moment to revisit whether our language reflects the full spirit of the peer movement.

Sometimes a single word tells people whether their lived experience is being welcomed into the system, or quietly edited out of it.

Keep Tellin’ The Story

Professor Peacock

Nothing Bad Happened


Content note: This piece includes discussion of sexual assault, sexual violence, consent, substance use, and BDSM imagery.

I titled this piece Nothing Bad Happened before I knew if I was ready to explain it.

Nothing Bad Happened (BW) – 2025

That’s often how my work functions. I process parts of my life through art before I fully understand what I’m touching. Sometimes intentionally. Sometimes not. This was an image I took down from the wall, looked at briefly, and put back. Not because it wasn’t good, but because I wasn’t ready to sit with it.

Then someone I care about asked me about the title. Someone I want to know better. I don’t let people get close easily, so the question caught me off guard. Instead of deflecting, I chose to answer.

This year, my themes have been connection, authenticity, community, and intentionality. Not the loud kind. Not the polished kind. The quiet kind that shows up sitting on a couch in a gallery, talking honestly about a piece of art.

So I told the truth.

Twelve years ago, I invited someone into my home under a sexual pretense. There were drugs. There was bondage. And there were substances involved that I did not consent to. I woke up hours later still tied up, alone, my home emptied. My credit cards, my car, my electronics gone. What happened changed the trajectory of my life.

I was sexually assaulted.

Our culture is obsessed with narrow definitions. I’m done shrinking my experience to fit them.

I did nothing wrong. What happened was not my fault. I did not get what I deserved.

I’ve done years of therapy since then. Different modalities. Different clinicians. Harm reduction because it works for me right now. Trauma doesn’t disappear just because time passes. It lives in the body. In desire. In fear. In the places you still avoid.

For me, that includes a complicated relationship with bondage. I’m drawn to it and wary of it at the same time. I want to experience it as something consensual, skillful, and safe. I can’t say I’ve fully reclaimed that yet.

This photograph was part of that work.

What you’re seeing is not my body. It’s someone else’s. What mattered to me was the care in the moment. The attention. The trust. The skill. I witnessed restraint practiced with intention and compassion, and I was able to capture it. I was present. I was grounded. Nothing bad happened.

When the idea for this exhibition came together, the title arrived instantly. Not as denial. As truth.

I lived through witnessing restraint. I lived through photographing it. And this time, there was no harm. That matters more than it might seem.

Maybe someday I’ll trust someone enough to go there myself. Maybe not. For now, I have my art. I have the stories behind it. And I have the act of creation, which has always been where I reclaim my power.

Art doesn’t erase trauma. But it interrupts it. It creates light where there used to be silence.

Nothing bad happened.

And that, for me, is a kind of healing.

Keep telling the story,

Sawubona,

Professor Peacock

USCHA reminded me: gratitude is how we honor the fight, and responsibility is how we continue it!


What USCHA Taught Me About Legacy and Belonging

This was my first USCHA (US Conference on HIV/AIDS), and I wasn’t ready for it. I’ve been to HINAC (HIV Is Not a Crime) and AIDS Watch each twice, but this was different. There’s a magic at USCHA that gets under your skin.

I travelled to USCHA as part of NMAC’s 50+ Cohort, joining others like me from around the country who are aging and living with HIV. I’m grateful for the experience and the connections I made.

I’m 57. I’ve been living with HIV for 13 years. That’s my place in the timeline. Not better, not worse – just mine. But when I saw the decades of HIV/AIDS laid out at the Friday plenary, the science, the struggle, the survival – it cracked something open in me. For the first time, I felt the weight of what it means to be a long-term survivor. And I also knew that wasn’t me.

I came along after protease inhibitors, after HAART reshaped the fight. When I was diagnosed in 2012, my doctor told me, “The guidance is changing. We used to tell people to wait. Now we recommend you start treatment right away.” He still gave me the option – that’s how new it was. I didn’t understand then how historic that moment was. I do now.

In the 80s, I was a teenager. In the 90s, I was climbing the corporate ladder, coming out of the closet, largely disconnected from my community. By the time I came out, the epidemic wasn’t invisible anymore, but it was still tearing through our communities. The mid-90s would become the deadliest years. And while that grief was swallowing a generation, I was safe in my bubble, largely untouched, largely unaware. That’s the part that haunts me. The loss I didn’t live. The fire I didn’t feel.

So no – I don’t carry the same survivor’s guilt as those who were told they would die and somehow lived. My guilt is different. It’s the guilt of surviving in a post-HAART world, of being shielded by privilege, of waking up to a history I wasn’t part of, but which shaped everything around me.

At USCHA, no one made me feel like an outsider. But I did. I think people at USCHA saw me at 57 and assume I’m a long-term survivor. I’m not. I’m someone aging with HIV, without that same story. That difference is mine to wrestle with.

And yet, USCHA gave me clarity. It gave me a way to honor what came before me and what is still unfolding now. Because just as I look back in gratitude, I also look forward, knowing that those who come of age in the U=U and PrEP era will have their own place in history, too.

To say USCHA was “life-changing” sounds cliché. But this was something deeper. A reckoning. A reminder that every place in the timeline matters, including mine. And for that – for the people who came before me, for the community that still carries me forward – I am deeply grateful.

Keep telling the story,

Professor Peacock

Note: These are my thoughts and my story. I used AI to make helpful edits to my ramblings and online journaling.