228950 Perceived barriers to HIV-related services in Western Kenya

Monday, November 8, 2010

Erick Amick, MPH, MA , The Kinsey Institute for Research in Sex, Gender, and Reproduction, Indiana University, Bloomington, IN
Lindsay Briggs, PhD, MPH , Department of Health & Community Services, California State University, Chico, Chico, CA
Ariane V. Hollub, PhD, CHES, OTR , Department of Health & Kinesiology, Texas A&M University, College Station, TX
Brian Dodge, PhD , Center for Sexual Health Promotion, Indiana University, Bloomington, IN
Michael Reece, PhD, MPH , Center for Sexual Health Promotion, Indiana University, Bloomington, IN
BACKGROUND: Understanding barriers to HIV program enrollment and adherence is critical to maximizing the effectiveness of treatment regimens in sub-Saharan Africa. Couples entering HIV-related services together, particularly Prevention of Mother to Child Transmission (pMTCT) programs, facilitate the engagement of both partners, which is effective in supporting total family health and reducing HIV transmission. Both structural and cultural barriers have been identified which prevent both individuals and couples from seeking HIV-related care in a range of cultures, however this study specifically assessed such barriers among a sample of individuals living with HIV in western Kenya.

METHODS: Data were collected from 146 men and women during 16 focus groups held at four HIV-related clinic sites across geographically diverse areas in western Kenya. Thematic analysis was used to assess perceptions of barriers to care.

RESULTS: Three predominant themes emerged as major barriers to initiating and participating in HIV-related care services: 1) HIV-related stigma, 2) infrastructure issues, and 3) social and cultural issues. Each theme was comprised of a complex set of concrete factors that participants cited as barriers to engagement and retention in HIV programs.

CONCLUSIONS: These findings provide insight into the perceived social, cultural and structural barriers that effect participation in HIV-related services in western Kenya. These findings also provide guidance for developing future HIV programs with a focus on broader engagement and increased retention strategies.

Learning Areas:
Administer health education strategies, interventions and programs
Clinical medicine applied in public health
Diversity and culture
Planning of health education strategies, interventions, and programs
Protection of the public in relation to communicable diseases including prevention or control
Public health or related organizational policy, standards, or other guidelines

Learning Objectives:
Identify barriers that inhibit men and women’s involvement in HIV programs in western Kenya. Discuss possible strategies to approach and overcome obstacles to involvement in HIV programs. Discuss implications for future research in this field.

Keywords: HIV/AIDS, Community Health Programs

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I collected the data for this study
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.