Care as hope, presence, and safety
Five lessons from HIV peer educators in Punjab.
In an HIV/AIDS center tucked away in a noisy Ludhiana neighborhood in Punjab, a peer educator leans forward and says quietly, “We don’t just bring people in. We sit with them. We talk.”
This is where care begins — not with pamphlets or protocols, but with real people, offering real presence. The center, a drop-in space run by a local nonprofit, offers a rare sense of safety: a confidential place to rest, talk, and access health support without judgement.
The need for this kind of care has never been greater. Between 2010 and 2023, new HIV/AIDS cases in Punjab rose nearly 117% annually. This epidemic hits hardest among people who inject drugs and female sex workers — populations where stigma, addiction, and systemic barriers to healthcare make prevention and treatment harder to reach.
To address this, we partnered with the Punjab State AIDS Control Society to create practical, culturally-grounded tools that combat stigma and support prevention, diagnosis, and treatment for people living with HIV/AIDS, those at risk, and their caregivers.
At the heart of this program are peer educators — people from high-risk communities with lived experience of the challenges their peers face, trained to provide support and guidance. They don’t just share information. They build trust, encourage testing, promote prevention, and offer care that feels close to home. Their role is integral to breaking through stigma and ensuring dignified care.
Earlier this year, I traveled to Punjab with a colleague to test some new communication tools we had developed for peer educators. But what unfolded went far beyond prototypes and messaging. It became a quiet but powerful lesson in the many forms care can take.
1. Care as perseverance
From the moment we stepped into the center, the peer educators’ knowledge was evident — not just in terms of information or facts, but in how they carried that knowledge. They wore it lightly, with humor, frustration, and a deep, weathered understanding of human behavior.
“They don’t listen to us when they’re high or have money,” said one peer educator working with people who inject drugs. “But when they’re broke or tired, that’s when they come. That’s when they’ll sit and hear us out.”
There was no self-congratulation. No heroics. Just a quiet, consistent effort to walk alongside people often judged or ignored. It was a reminder that caregiving here isn’t abstract. It’s lived, daily work that refuses to give up — grounded in trust and the belief that every person is worth waiting for.
2. Care as unlearning
We didn’t go in with presentations. We didn’t even begin with questions. We introduced simple, visual tools built around games and stories that were designed to spark conversations. This covered everything from common myths and misconceptions, testing, overdose, opioid substitution therapy, condom negotiation, and sexually transmitted infection symptoms.
For instance, in one of the games participants had to call out what they believed to be true or false about HIV/AIDS: Do mosquitoes spread HIV? Can a baby be born HIV-negative to a positive mother? Is love enough reason to skip a condom?
With each sentence came laughter, debate, and a gentle re-examination of things people had always been told.
“You can see it in their eyes,” one participant said, quoting a common myth, when asked whether testing is the only way to know someone’s HIV status. “That’s how you know someone has HIV.”
We witnessed how information travels, transforms, hardens into beliefs, and how beliefs become facts. Games like these helped uncover those beliefs without judgement or confrontation. They created space to question and unlearn, and that too, is care.
3. Care as co-learning
But unlearning is only one side of the story. What we witnessed next was how peer educators don’t just dismantle old myths — they rebuild knowledge in ways that feel lived and local. We watched them break down the overdose journey of Mandeep, a fictional character we’d created for one of our prototypes. To ground the story further, they added their own insights: what really leads to overdoses, what panic feels like, and how the body shuts down. They showed us what happens between the lines of our toolkit — bringing it to life with their own examples, idioms, and colloquial phrases that made the message real and relatable.
“How many times have I revived someone who overdosed while we were using drugs together?” remarked one peer educator, who previously injected drugs. “Four. At least four. You just do what you can in that moment.”
The conversation wasn’t linear. It didn’t need to be. It was real. And it made us realize that knowledge doesn’t flow one way — it loops back, teaching us what truly matters.
4. Care as collective strength
The female sex worker peer educators carried their strength differently. Many had survived violence, coercion, addiction, and chose to come back for others. In one game, they role-played client scenarios to build their condom negotiation skills, giving names and personalities to their clients: the aggressive ones, the persuasive ones, the ones who ignore consent, and so on.
What emerged was not fear, but resourcefulness. They shared strategies, practiced refusals, laughed over familiar client tricks, all while holding space for those who hadn’t found their voice yet.
“We say, it’s about your and our safety. We both have families to go back to,” one peer educator explained. “You don’t need a bigger reason than that.”
What struck me was how they framed even refusal as a collective act. If one woman felt like she couldn’t say no to a coercive client, another would step in and speak for her. There was power in that.
5. Care as hope
When it came to sexually transmitted infections, we tried another story-based approach. We shared the narrative of a fictional person who had ignored early symptoms and faced serious consequences. It wasn’t dramatic; just something real enough to open a window.
“You should end the story with her getting better,” one peer educator said. “If you leave her in pain, people will shut down.”
They were right. Fear doesn’t always educate. Sometimes, it paralyzes.
The reflection that followed was deeply personal — about recognizing pain, advocating for one’s body, and knowing when to act.
Caring without conditions
Our visit reminded us that designing effective communication doesn’t start in front of a screen. It begins in rooms like these, with conversations where people speak in truths that can’t be Googled. People living with or at risk of HIV/AIDS don’t just need information or instructions. They need care that is ongoing, grounded in trust, and shaped by the realities of their lives. This came alive in not just what we heard, but what we witnessed.
The peer educators weren’t just helping us test tools — they showed us what care looks like when it’s offered without conditions: Care as persistence. As unlearning. As shared knowledge. As collective strength. As hope.
What stayed with me wasn’t just the feedback on the prototypes. It was the steady, often invisible labor of those who show up again and again — not to deliver messages from a distance, but to walk alongside others. To meet people in the middle of their lives, not at the edges of our expectations.
That’s the kind of care that makes everything else possible.
A special thanks to Anoop Mohan for the illustrations and to Tanaya Jagtiani for the editorial support!
Simerneet Bajwa
Senior Lead, Health Communications
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