Understanding Women’s Preferences for Prevention of Mother-to-Child HIV Transmission Services in Kenya

Author:

Humphrey John1,Wanjama Esther2,Carlucci James G.3,Naanyu Violet4,Muli Lindah5,Were Edwin6,McGuire Alan78,Nyandiko Winstone M.9,Songok Julia9,Zimet Gregory3,Wools-Kaloustian Kara1

Affiliation:

1. Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA

2. Department of Pediatrics, Moi Teaching and Referral Hospital, Eldoret, Kenya

3. Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA

4. Department of Sociology, Psychology, and Anthropology, Moi University School of Arts and Social Science, Eldoret, Kenya

5. Department of Research, Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya

6. Department of Obstetrics and Gynaecology, Moi University College of Health Sciences, Eldoret, Kenya

7. Department of Psychology, Indiana University-Purdue University, Indianapolis, IN, USA

8. Department of Health Services Research and Development, Richard L. Roudebush VAMC, Indianapolis, IN, USA

9. Department of Child Health and Pediatrics, Moi University College of Health Sciences, Eldoret, Kenya,

Abstract

Background and Objective Understanding the preferences of women living with HIV (WLH) for the prevention of mother-to-child HIV transmission (PMTCT) services is important to ensure such services are person-centered. Methods From April to December 2022, we surveyed pregnant and postpartum WLH enrolled at five health facilities in western Kenya to understand their preferences for PMTCT services. WLH were stratified based on the timing of HIV diagnosis: known HIV-positive (KHP; before antenatal clinic [ANC] enrollment), newly HIV-positive (NHP; on/after ANC enrollment). Multivariable logistic regression was used to determine associations between various service preferences and NHP (vs. KHP) status, controlling for age, facility, gravidity, retention status, and pregnancy status. Results Among 250 participants (median age 31 years, 31% NHP, 69% KHP), 93% preferred integrated versus non-integrated HIV and maternal-child health (MCH) services; 37% preferred male partners attend at least one ANC appointment (vs. no attendance/no preference); 54% preferred support groups (vs. no groups; 96% preferred facility – over community-based groups); and, preferences for groups was lower among NHP (42%) versus KHP (60%). NHP had lower odds of preferring support groups versus KHP (aOR 0.45, 95% CI 0.25–0.82), but not the other services. Conclusion and Global Health Implications Integrated services were highly preferred by WLH, supporting the current PMTCT service model in Kenya. Further research is needed to explore the implementation of facility-based support groups for WLH as well as the reasons underlying women’s preferences.

Publisher

Scientific Scholar

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