For HIV-positive individuals living in socially vulnerable circumstances, the complexities of accessing and navigating healthcare system can be overwhelming. Peer-driven interventions (PDIs) are increasingly being recognized as effective ways of addressing barriers to HIV care in the USA. The present study is a qualitative investigation of barriers, challenges, and facilitators to implementation of a peer integration program at three health centers in the USA. Findings reveal that health center staff and HIV-positive patients support the integration of HIV-positive peers on multidisciplinary healthcare teams. However, challenges related to peer-clinician communication and the risk of emotional burnout for peers may hinder program efficacy and sustainability. Practical implications and suggestions for improving the peer integration program in light of these findings are also discussed.