Assessing Social and Cultural Barriers to Family Centered HIV Care Services in Western Kenya

Background: In western Kenya HIV interventions continue to face a number of challenges in recruiting and retaining individuals at risk for HIV infection and transmission. Apart from high levels of HIV stigma, widespread poverty, and low levels of education, HIV interventions in Kenya are challenged with other social and cultural barriers, which can negatively impact the program's influence on HIV prevention and treatment.

Methods: Data were collected from 146 men and women engaged in family centered HIV treatment and prevention services in western Kenya. Sixteen focus groups were conducted to assess social and cultural barriers to seeking and adhering to HIV-related services. Participants identified several key social and cultural barriers, which were likely to limit the extent in which families and individuals might engage in HIV programs.

Results: Participants identified socially prescribed behaviors and strict traditional gender roles as prohibitive factors from involving themselves in HIV services. Despite the desire to receive HIV care, participants indicated rigid social expectations for men and women's behavior to be contradictory with certain components of family centered HIV programs. When gender roles or socially acceptable behaviors were perceived to be threatened participants were less likely to comply with HIV treatment regimens.

Conclusions: Findings from this study and participant suggestions provide guidance for the development of more culturally sensitive modes of HIV service delivery in western Kenya. These findings may also offer insight for strategy development focusing on increased engagement and retention among participants in HIV programs in other regions of sub-Saharan Africa.