Peer work programmes are firmly grounded on values of equality. Peers share experiences, background, and recognise (parts of) a common identity.  Although each individual is different, with different personal characteristics, people in peer groups uniquely recognise their fellow peers, not as identical, but on equal basis. An equal relationship is key in peer work.

“Being accepted as a peer is a social process of identifying, and being identified, as part of a group, network, community or culture.  It is not a decision that can be made by others outside the process.”

Annie Madden, Jude Byrne, Nicky Bath in Who's peering at who? Junkmail, Vol. 4, AIVL.






Peers who are involved in a peer support project may possibly work in a hierarchical structure, may have different main personal or professional characteristics than some of their fellow peers, but their work is based on equal relationships and there is a commonality among them.  They have equal relations with their peers in the target group, equal relations with peer support colleagues and equal relations with professionals without experiential expertise.

The principle of equality in peer support highlights the significance of different alternatives to the traditional client-provider social worker model.  Peer support offers both professionals and peers a different health promotion approach and method, based on equality and mutual coaching.  It provides an opportunity to focus services/goals on the direct, current needs members of the community present with, thus meeting them where they are.


Peer work aims to support people to be in the driver’s seat of their own lives, to be able to decide on their own daily life and destiny, have the opportunity to decide how the process of personal self-determination will occur, and where it will lead.

This approach to determine or self-define your own life’s goals can also be called ‘ownership’ and is closely linked to emancipation and empowerment processes.

Every person should have the opportunity to determine what’s best for him. I for instance have an allergy against ‘doing-what-I-am supposed-to do’. To do what other think is desirable or is what they tolerate. When I came out of rehab in the 1980s, I wanted again to be involved in the drug scene. I got the opportunity to start a HIV pevention initiative, NO RISK. The idea was to inform and support injecting drug users who did not have contact with drug services. I noticed that they appreciated our approach and our information. Straight from the life experts. Soon we included social support and advocacy for the interests of users. On top of that I had the opportunity to support colleagues in their critisism on drug services and drug policy.

Theo van Dam, drug user activist, The Netherlands

Peer programmes focus on empowerment within structured projects, in which peers have meaningful roles, decision- making power and are involved in programme development and delivery.  This principle is even more important because there is an initial imbalance between the two key stakeholder groups - professionals and the target group.

Peer support seeks to achieve community level change and objectives. However, it is recognised that individual peer workers may receive personal benefits that help them progress in their lives and also potentially in addressing drug-related problems.  Sam Friedman (a US researcher on HIV and drug use) has described this effect as ‘redemption through social struggle’.



Genuine and full involvement

Peer support programmes encourage open dialogue and discussion and are based on principles of genuine and full participation.

Participants in peer work programmes and their peer colleagues in the target group must be meaningfully involved in the development and implementation of policies, delivery of services and other activities.

People should be involved in decisions that directly affect them and their daily lives.  It is important to note that when high levels of participation are offered without the sharing of power, peers may actually have a heightened experience of powerlessness.

Building on strengths

Peer work programmes are more than a response to a technical need or to a specific problem.  Meaningful peer work has a positive focus, and builds on individual and community strengths, and the experience and skills of both peer workers and the target group.  Good peer work principally builds on people’s capacity and not primarily on their limitations, needs and problems.

Peer support is an organised way of extending what is often already happening in daily life:  what people know, have experienced, and their capacity to deal with it. Peer work can be seen as enabling and extending organic learning.

The main source of peers’ capacity to communicate and to support is their shared experience and shared identity with (other) members of the target group.

Community development

Peer work involves individuals, relatives, families and wider social networks.

Peer support programmes are closely linked with active community involvement and are largely about creating possibilities that enable communities in active participation and decision-making.

Peer support programmes are embedded in approaches that address root causes of marginalisation, exclusion, and the discrimination of vulnerable communities in terms of essential rights, opportunities and resources.  The programmes strive for the social inclusion of these communities, especially by supporting and strengthening peer initiatives in the community.

Peer work covers a whole range of factors that influence marginalised individuals:  it does not simply hand over a message of what to do.  Peer programmes can benefit from individuals’ existing social networks and the (informal) infrastructures within a community.

Peer support is bigger than the sum of the individual relations or social network.  It is about supporting community action and strengthening community networks and relations.

The Australian Injecting and Illicit Drug Users League (AIVL) League list some specific areas of community action in their document on peer work: http://www.aivl.org.au/files/FrameworkforPeerEducation.pdf

  • strengthening drug user peer networks to enhance communication and mutual support, so as to create social environments in which health-promoting behaviours become less difficult
  • connecting networks of users to health resources, services and programmes, and increasing users' confidence in using them
  • advocating on behalf of users with representatives of health services and programmes, to increase their openness and sensitivity to users’ needs
  • reinforcing aspects of the norms within user networks that have a positive influence on wellbeing and influencing change in those that don’t
  • providing skills and, if necessary, resources to train and empower drug users to do any of the aforementioned themselves.



Meeting people where they are

An important element of peer support is to offer options and realistic alternatives, including a range of different support interventions intended to meet people where they are at, at any stage they may be at. This might be a specific  question or dilemma;  a technical issue (e.g. ‘How can I check the quality of my drug?’);   or a request for support on another, more reflective and personal level. (e.g. ‘Should I continue with injecting?’ ‘What can I do for my peers?).

Good peer support provides a range of alternatives for people, from supporting smaller improvements (a change in behaviour, a voluntary contribution to a service) to much more complicated steps (like becoming active in a self-organised group).



Each alternative might lead to a valuable improvement of a person’s situation.  Small steps forward should be encouraged and aiming for second-best options (or even third- or fourth-best options) may sometimes lead to considerable improvement in a person’s life.

The concept of ‘acceptance’ is a basic notion regarding AIDS prevention methods for reaching drug users effectively.  The key of the so-called acceptance model is recognition of the drug user as a human being with the same rights as other human beings.  That means, for instance, that s/he has the right to choose the way s/he wants to live and if and how s/he wants assistance.  One consequence of this idea is to offer assistance without formulating prerequisites such as stopping drug use.  Offering ‘low threshold’ health services increases the possibility of reaching drug users effectively.

Mutual respect

An important underpinning peer support issue is related to the respect of individuals’ lifestyles, personal choices and experiences, their illegal activities and their vulnerability.  Every initiative has to acknowledge these aspects of vulnerability and has to operate non-judgementally, delicately and respectfully.  Everyone needs to be treated  respectfully and with dignity.  In particular, the identity of, and information about an individual must be treated with greatest sense of confidentiality and privacy.

“Revealing identity and personal information can have unpleasant, inconvenient, and even disastrous consequences. The present social and legal climate makes illicit drug use, and especially injecting, a highly fraught activity. We have a moral responsibility to conduct our activities in a way that avoids these consequences. We also have a moral responsibility to protect the confidential information we may acquire about people not just from authorities, but from other users as well.”

Annie Madden in AIVL booklet ‘A framework for peer education by drug-user organisations’



Key principles



Peer work, as described and promoted in the Correlation II programme, is based on a strong commitment to:

  • public health
  • social inclusion
  • empowerment
  • mutual respect
  • and meaningful involvement.


We consider the following principles essential element peer work:

  • Equality
  • Self-determination
  • Genuine and full involvement
  • Building on strengths
  • Community development
  • Meeting people where they are
  • Mutual respect