Perceptions and Experiences of Integrated Service Delivery Among Women Living with HIV Attending Reproductive Health Services in Kenya: A Mixed Methods Study

• Published in: AIDS and behavior Vol. 20; no. 9; pp. 2130 - 2140
• Main Authors: Colombini, M., Mayhew, S. H., Mutemwa, R., Kivunaga, J., Ndwiga, C.
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.09.2016; Springer Nature B.V
• Subjects: Acquired immune deficiency syndrome; Adult; AIDS; Anti-HIV Agents - therapeutic use; Clients; Communication; Decisions; Delivery of Health Care, Integrated - organization & administration; Family planning; Family Planning Services - organization & administration; Female; Females; Health care; Health Psychology; Health services; Health services utilization; HIV; HIV Infections - drug therapy; HIV Infections - psychology; Human immunodeficiency virus; Humans; Infectious Diseases; Interviews as Topic; Kenya; Lentivirus; Management systems; Medical decision making; Medicine; Medicine & Public Health; Original Paper; Patient Acceptance of Health Care - ethnology; Patient Acceptance of Health Care - psychology; Perception; Perceptions; Public Health; Public sector; Qualitative analysis; Qualitative Research; Reproduction; Reproductive health; Reproductive Health Services - organization & administration; Sexual Behavior; Sexual health; Sexually transmitted diseases; Social integration; Social services delivery; Social Stigma; STD; Women; Womens health; Kenya; Perceptions; Integration; HIV; Clients’ experiences; Kenya
• DOI: 10.1007/s10461-016-1373-2
• ISSN: 1090-7165

This is one of the few studies that explores preferences of and experiences with integrated sexual and reproductive health (SRH)-HIV care among users of mainstream family planning and postnatal care services who are women living with HIV (WLWH). This paper reports on the quantitative data from 179 clients attending public sector clinics and from 30 qualitative in-depth interviews with WLHIV in Kenya. Quantitative data show that integration is happening for the vast majority of these clients at their last HIV visit. However, qualitative data show that very often the care received by WLWH is fragmented as providers do not offer multiple same-day appointments for FP and ARV refills. Our study has shown factors that could either prevent or enable receipt of integrated SRH and HIV care for WLWH. To address these factors, management systems need to be able to support providers to make flexible decisions and facilitate better coordination and communication across clinics within facilities.