287757
Mobility processes, empowerment and engagement in HIV care among HIV+ women in Kenya
Carol Camlin, Ph.D., M.P.H.
,
Department of Obstetrics, Gynecology & Reproductive Sciences, and Center for AIDS Prevention Studies, University of California at San Francisco, San Francisco, CA
Mallory Johnson, Ph.D.
,
Center for AIDS Prevention Studies, University of California at San Francisco, San Francisco, CA
Zachary Kwena, MA
,
Kenyan Medical Research Institute (KEMRI), Kisumu, Kenya
Elizabeth Bukusi, MD, MPH, PGD, PHD
,
Centre for Microbiology Research, Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
Craig Cohen, MD, MPH
,
OB/GYN and Reproductive Sciences, University of California, San Francisco, San Francisco, CA
BACKGROUND: Women's ability to exercise agency is central to theories of women's empowerment. In sub-Saharan Africa, women often migrate following catastrophic shocks to households due to poverty and HIV. Yet women also migrate for better standards of living, independence from the often patriarchal norms of rural cultures, and a modernity characterized by more egalitarian gender relations. Women's migration is also linked to higher HIV transmission and acquisition risks, and may play an under-recognized role in the persistence of HIV/AIDS. No research to date has assessed the impact of HIV/AIDS on women's mobility and empowerment. METHODS: This study explores interconnections between empowerment and mobility among HIV+ women, using in-depth, qualitative interviews conducted with 15 HIV-positive migrant women living in the Kisumu area of Nyanza Province, Kenya, in January-June 2013. We pursue two questions: to what extent does women's mobility present barriers to their engagement in HIV care and treatment? To what extent does mobility result in an expansion of life choices and greater ability to make health-enhancing decisions such as enrolling and remaining engaged in care? RESULTS: Preliminary findings suggest that many HIV+ women travel far from home to access HIV care, employing mobility as a strategy to reduce their vulnerability to gender-based violence and stigma. CONCLUSIONS: Programs to engage and retain HIV-positive female migrants in HIV care and treatment are urgently needed, but must be designed to facilitate the empowering aspects of mobility for women, while addressing the barriers that mobility may present to women's agency to make health-enhancing decisions.
Learning Areas:
Public health or related public policy
Social and behavioral sciences
Learning Objectives:
Assess barriers HIV+ female migrants face in accessing and remaining engaged in HIV care and treatment. Specifically, participants will learn about the extent to which, and how, women’s mobility presents barriers to their engagement in HIV care and treatment; and critically appraise findings regarding the extent to which, and how, women's mobility results in an expansion of life choices and greater ability to make health-enhancing decisions such as enrolling and remaining engaged in care.
Keywords: Women and HIV/AIDS, Access to Care
Presenting author's disclosure statement:Qualified on the content I am responsible for because: I am trained in public health and population studies, with 15 years experience in
sexual and reproductive health and HIV prevention in sub-Saharan Africa. My
research focuses on the overlooked role that women’s participation in migration
may play in sustaining HIV epidemics in Southern and East Africa. I am P.I. of a 5-year NIMH-funded study that aims to assess how women’s participation in migration in Kenya contributes to their high HIV transmission and acquisition risks.
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.
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