Perspectives of healthcare providers and HIV-affected individuals and couples during the development of a Safer Conception Counseling Toolkit in Kenya: Stigma, fears, and recommendations for the delivery of services

  • AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV, Volume 28, No. 6, Year 2016

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Study Justification:
– Reproduction is important to HIV-affected individuals and couples.
– Healthcare providers (HCPs) play a crucial role in providing resources for safe conception.
– HIV-affected individuals need access to information on safer methods of conception.
– The objective of the study was to develop a Safer Conception Counseling Toolkit for HCPs.
Highlights:
– Qualitative study conducted among HCPs and HIV-affected individuals and couples in Kenya.
– In-depth interviews and focus group discussions were conducted to develop and refine the Toolkit.
– Participants emphasized the need for a safer conception counseling program for HCPs.
– Routine provision of safer conception counseling may enhance reproductive autonomy and promote maternal and child health.
– The Toolkit may help dispel stigma and fears associated with reproduction in HIV-affected couples.
Recommendations:
– Evaluate the Safer Conception Toolkit to support its implementation in HIV care and treatment programs.
– Conduct additional research to assess the effectiveness of the Toolkit in other HIV endemic regions of sub-Saharan Africa.
Key Role Players:
– Healthcare providers (HCPs)
– HIV-affected individuals and couples
– Researchers and evaluators
– Policy makers and program managers
Cost Items for Planning Recommendations:
– Training and capacity building for HCPs
– Development and dissemination of the Safer Conception Toolkit
– Research and evaluation activities
– Program implementation and monitoring
– Stakeholder engagement and coordination efforts

The strength of evidence for this abstract is 8 out of 10.
The evidence in the abstract is strong, but additional research is needed to evaluate the Safer Conception Toolkit.

Reproduction is important to many HIV-affected individuals and couples and healthcare providers (HCPs) are responsible for providing resources to help them safely conceive while minimizing the risk of sexual and perinatal HIV transmission. In order to fulfill their reproductive goals, HIV-affected individuals and their partners need access to information regarding safer methods of conception. The objective of this qualitative study was to develop a Safer Conception Counseling Toolkit that can be used to train HCPs and counsel HIV-affected individuals and couples in HIV care and treatment clinics in Kenya. We conducted a two-phased qualitative study among HCPs and HIV-affected individuals and couples from eight HIV care and treatment sites in Kisumu, Kenya. We conducted in-depth interviews (IDIs) and focus group discussions (FGDs) to assess the perspectives of HCPs and HIV-affected individuals and couples in order to develop and refine the content of the Toolkit. Subsequently, IDIs were conducted among HCPs who were trained using the Toolkit and FGDs among HIV-affected individuals and couples who were counseled with the Toolkit. HIV-related stigma, fears, and recommendations for delivery of safer conception counseling were assessed during the discussions. One hundred and six individuals participated in FGDs and IDIs; 29 HCPs, 49 HIV-affected women and men, and 14 HIV-serodiscordant couples. Participants indicated that a safer conception counseling and training program for HCPs is needed and that routine provision of safer conception counseling may promote maternal and child health by enhancing reproductive autonomy among HIV-affected couples. They also reported that the Toolkit may help dispel the stigma and fears associated with reproduction in HIV-affected couples, while supporting them in achieving their reproductive goals. Additional research is needed to evaluate the Safer Conception Toolkit in order to support its implementation and use in HIV care and treatment programs in Kenya and other HIV endemic regions of sub-Saharan Africa.

N/A

The study recommends the development of a Safer Conception Counseling Toolkit to train healthcare providers (HCPs) and counsel HIV-affected individuals and couples in Kenya. This toolkit aims to provide resources and information on safer methods of conception for HIV-affected individuals and their partners, while minimizing the risk of HIV transmission. The study found that a safer conception counseling and training program for HCPs is needed, and routine provision of safer conception counseling may promote maternal and child health by enhancing reproductive autonomy among HIV-affected couples. The Toolkit is expected to help dispel stigma and fears associated with reproduction in HIV-affected couples, while supporting them in achieving their reproductive goals. Further research is needed to evaluate the effectiveness of the Safer Conception Toolkit and support its implementation in HIV care and treatment programs in Kenya and other HIV endemic regions of sub-Saharan Africa.
AI Innovations Description
The recommendation from the study is to develop a Safer Conception Counseling Toolkit that can be used to train healthcare providers (HCPs) and counsel HIV-affected individuals and couples in HIV care and treatment clinics in Kenya. This toolkit aims to provide resources and information on safer methods of conception for HIV-affected individuals and their partners, while minimizing the risk of HIV transmission. The study found that a safer conception counseling and training program for HCPs is needed, and routine provision of safer conception counseling may promote maternal and child health by enhancing reproductive autonomy among HIV-affected couples. The Toolkit is expected to help dispel stigma and fears associated with reproduction in HIV-affected couples, while supporting them in achieving their reproductive goals. Further research is needed to evaluate the effectiveness of the Safer Conception Toolkit and support its implementation in HIV care and treatment programs in Kenya and other HIV endemic regions of sub-Saharan Africa.
AI Innovations Methodology
The methodology used in this study involved conducting a two-phased qualitative research approach. The study was conducted in eight HIV care and treatment sites in Kisumu, Kenya. The first phase involved in-depth interviews (IDIs) and focus group discussions (FGDs) with healthcare providers (HCPs) and HIV-affected individuals and couples to gather their perspectives on safer conception counseling and the development of the Safer Conception Counseling Toolkit.

During these discussions, HIV-related stigma, fears, and recommendations for the delivery of safer conception counseling were assessed. A total of 29 HCPs, 49 HIV-affected women and men, and 14 HIV-serodiscordant couples participated in the IDIs and FGDs, resulting in a sample size of 106 individuals.

The second phase of the study involved implementing the Safer Conception Counseling Toolkit. HCPs were trained using the Toolkit, and HIV-affected individuals and couples were counseled with the Toolkit. Subsequently, additional IDIs were conducted with the trained HCPs, and FGDs were conducted with the HIV-affected individuals and couples who received counseling with the Toolkit.

The qualitative data collected from the IDIs and FGDs were analyzed to identify themes and patterns related to HIV-related stigma, fears, and recommendations for safer conception counseling. The findings from the analysis were used to develop and refine the content of the Safer Conception Counseling Toolkit.

The study concluded that a safer conception counseling and training program for HCPs is needed, and routine provision of safer conception counseling may promote maternal and child health by enhancing reproductive autonomy among HIV-affected couples. The Toolkit was found to have the potential to dispel stigma and fears associated with reproduction in HIV-affected couples while supporting them in achieving their reproductive goals.

The publication of this study can be found in the journal AIDS Care – Psychological and Socio-Medical Aspects of AIDS/HIV, Volume 28, No. 6, in the year 2016.


Statistics:
Citations: 25
Identifiers:
DOI: 10.1080/09540121.2016.1153592
ISSN: 09540121
Research Areas:
Health System and Policy, Infectious Diseases, Maternal Access, Maternal and Child Health, Quality of Care, Sexual and Reproductive Health
Study Countries:
Kenya
Study Approach:
Qualitative
Participants Gender:
Male & Female
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