Impacts of the COVID-19 pandemic on access to HIV and reproductive health care among women living with HIV (WLHIV) in Western Kenya: A mixed methods analysis
IntroductionThe COVID-19 pandemic has impacted access to health services. Our objective was to understand the pandemic's impact on access to HIV, pregnancy, and family planning (FP) care among women living with HIV (WLHIV).MethodsData were collected after June 2020, when questions about the pan...
| Main Authors: | , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-12-01
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| Series: | Frontiers in Global Women's Health |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fgwh.2022.943641/full |
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| author | Caitlin Bernard Shukri A. Hassan John Humphrey Julie Thorne Mercy Maina Beatrice Jakait Evelyn Brown Nashon Yongo Caroline Kerich Sammy Changwony Shirley Ru W. Qian Andrea J. Scallon Sarah A. Komanapalli Leslie A Enane Patrick Oyaro Lisa L. Abuogi Kara Wools-Kaloustian Rena C. Patel |
| author_facet | Caitlin Bernard Shukri A. Hassan John Humphrey Julie Thorne Mercy Maina Beatrice Jakait Evelyn Brown Nashon Yongo Caroline Kerich Sammy Changwony Shirley Ru W. Qian Andrea J. Scallon Sarah A. Komanapalli Leslie A Enane Patrick Oyaro Lisa L. Abuogi Kara Wools-Kaloustian Rena C. Patel |
| author_sort | Caitlin Bernard |
| collection | DOAJ |
| description | IntroductionThe COVID-19 pandemic has impacted access to health services. Our objective was to understand the pandemic's impact on access to HIV, pregnancy, and family planning (FP) care among women living with HIV (WLHIV).MethodsData were collected after June 2020, when questions about the pandemic were added to two ongoing mixed methods studies using telephone surveys and in-depth interviews among WLHIV in western Kenya. The Chaguo Langu (CL) study includes primarily non-pregnant WLHIV receiving HIV care at 55 facilities supported by AMPATH and the Opt4Mamas study includes pregnant WLHIV receiving antenatal care at five facilities supported by FACES. Our outcomes were self-reported increased difficulty refilling medication, accessing care, and managing FP during the pandemic. We summarized descriptive data and utilized multivariable logistic regression to evaluate predictors of difficulty refilling medication and accessing care. We qualitatively analyzed the interviews using inductive coding with thematic analysis.ResultsWe analyzed 1,402 surveys and 15 in-depth interviews. Many (32%) CL participants reported greater difficulty refilling medications and a minority (14%) reported greater difficulty accessing HIV care during the pandemic. Most (99%) Opt4Mamas participants reported no difficulty refilling medications or accessing HIV/pregnancy care. Among the CL participants, older women were less likely (aOR = 0.95, 95% CI: 0.92–0.98) and women with more children were more likely (aOR = 1.13, 95% CI: 1.00–1.28) to report difficulty refilling medications. Only 2% of CL participants reported greater difficulty managing FP and most (95%) reported no change in likelihood of using FP or desire to get pregnant. Qualitative analysis revealed three major themes: (1) adverse organizational/economic implications of the pandemic, (2) increased importance of pregnancy prevention during the pandemic, and (3) fear of contracting COVID-19.DiscussionThe two unique participant groups included in our study encountered overlapping problems during the COVID-19 epidemic. Access to HIV services and antiretrovirals was interrupted for a large proportion of non-pregnant WLHIV in western Kenya, but access to pregnancy/family planning care was less affected in our cohort. Innovative solutions are needed to ensure HIV and reproductive health outcomes do not worsen during the ongoing pandemic. |
| first_indexed | 2024-04-12T02:50:39Z |
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| id | doaj.art-5f4d5ca9430d42fcae242024b28cb2f4 |
| institution | Directory Open Access Journal |
| issn | 2673-5059 |
| language | English |
| last_indexed | 2024-04-12T02:50:39Z |
| publishDate | 2022-12-01 |
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| record_format | Article |
| series | Frontiers in Global Women's Health |
| spelling | doaj.art-5f4d5ca9430d42fcae242024b28cb2f42022-12-22T03:51:00ZengFrontiers Media S.A.Frontiers in Global Women's Health2673-50592022-12-01310.3389/fgwh.2022.943641943641Impacts of the COVID-19 pandemic on access to HIV and reproductive health care among women living with HIV (WLHIV) in Western Kenya: A mixed methods analysisCaitlin Bernard0Shukri A. Hassan1John Humphrey2Julie Thorne3Mercy Maina4Beatrice Jakait5Evelyn Brown6Nashon Yongo7Caroline Kerich8Sammy Changwony9Shirley Ru W. Qian10Andrea J. Scallon11Sarah A. Komanapalli12Leslie A Enane13Patrick Oyaro14Lisa L. Abuogi15Kara Wools-Kaloustian16Rena C. Patel17Department of Obstetrics and Gynecology, Indiana University School of Medicine, Indianapolis, IN, United StatesDepartment of Medicine, University of Washington, Seattle, WA, United StatesDepartment of Medicine, Indiana University School of Medicine, Indianapolis, IN, United StatesDepartment of Obstetrics and Gynecology, University of Toronto, Toronto, ON, CanadaAcademic Model Providing Access to Healthcare (AMPATH), Eldoret, KenyaAcademic Model Providing Access to Healthcare (AMPATH), Eldoret, KenyaUW Kenya, Nairobi, KenyaUW Kenya, Nairobi, KenyaAcademic Model Providing Access to Healthcare (AMPATH), Eldoret, KenyaAcademic Model Providing Access to Healthcare (AMPATH), Eldoret, KenyaDepartment of Public Health, University of Washington, Seattle, WA, United StatesJackson School of International Studies, University of Washington, Seattle, WA, United StatesIndiana University School of Medicine, Indianapolis, IN, United States0Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, United States1Health Innovations Kenya (HIK), Kisumu, Kenya2Department of Pediatrics, University of Colorado, Denver, CO, United StatesDepartment of Medicine, Indiana University School of Medicine, Indianapolis, IN, United StatesDepartment of Medicine, University of Washington, Seattle, WA, United StatesIntroductionThe COVID-19 pandemic has impacted access to health services. Our objective was to understand the pandemic's impact on access to HIV, pregnancy, and family planning (FP) care among women living with HIV (WLHIV).MethodsData were collected after June 2020, when questions about the pandemic were added to two ongoing mixed methods studies using telephone surveys and in-depth interviews among WLHIV in western Kenya. The Chaguo Langu (CL) study includes primarily non-pregnant WLHIV receiving HIV care at 55 facilities supported by AMPATH and the Opt4Mamas study includes pregnant WLHIV receiving antenatal care at five facilities supported by FACES. Our outcomes were self-reported increased difficulty refilling medication, accessing care, and managing FP during the pandemic. We summarized descriptive data and utilized multivariable logistic regression to evaluate predictors of difficulty refilling medication and accessing care. We qualitatively analyzed the interviews using inductive coding with thematic analysis.ResultsWe analyzed 1,402 surveys and 15 in-depth interviews. Many (32%) CL participants reported greater difficulty refilling medications and a minority (14%) reported greater difficulty accessing HIV care during the pandemic. Most (99%) Opt4Mamas participants reported no difficulty refilling medications or accessing HIV/pregnancy care. Among the CL participants, older women were less likely (aOR = 0.95, 95% CI: 0.92–0.98) and women with more children were more likely (aOR = 1.13, 95% CI: 1.00–1.28) to report difficulty refilling medications. Only 2% of CL participants reported greater difficulty managing FP and most (95%) reported no change in likelihood of using FP or desire to get pregnant. Qualitative analysis revealed three major themes: (1) adverse organizational/economic implications of the pandemic, (2) increased importance of pregnancy prevention during the pandemic, and (3) fear of contracting COVID-19.DiscussionThe two unique participant groups included in our study encountered overlapping problems during the COVID-19 epidemic. Access to HIV services and antiretrovirals was interrupted for a large proportion of non-pregnant WLHIV in western Kenya, but access to pregnancy/family planning care was less affected in our cohort. Innovative solutions are needed to ensure HIV and reproductive health outcomes do not worsen during the ongoing pandemic.https://www.frontiersin.org/articles/10.3389/fgwh.2022.943641/fullCOVID-19family planning (FP)pregnancyHIVantiretroviral (ARV) therapy |
| spellingShingle | Caitlin Bernard Shukri A. Hassan John Humphrey Julie Thorne Mercy Maina Beatrice Jakait Evelyn Brown Nashon Yongo Caroline Kerich Sammy Changwony Shirley Ru W. Qian Andrea J. Scallon Sarah A. Komanapalli Leslie A Enane Patrick Oyaro Lisa L. Abuogi Kara Wools-Kaloustian Rena C. Patel Impacts of the COVID-19 pandemic on access to HIV and reproductive health care among women living with HIV (WLHIV) in Western Kenya: A mixed methods analysis Frontiers in Global Women's Health COVID-19 family planning (FP) pregnancy HIV antiretroviral (ARV) therapy |
| title | Impacts of the COVID-19 pandemic on access to HIV and reproductive health care among women living with HIV (WLHIV) in Western Kenya: A mixed methods analysis |
| title_full | Impacts of the COVID-19 pandemic on access to HIV and reproductive health care among women living with HIV (WLHIV) in Western Kenya: A mixed methods analysis |
| title_fullStr | Impacts of the COVID-19 pandemic on access to HIV and reproductive health care among women living with HIV (WLHIV) in Western Kenya: A mixed methods analysis |
| title_full_unstemmed | Impacts of the COVID-19 pandemic on access to HIV and reproductive health care among women living with HIV (WLHIV) in Western Kenya: A mixed methods analysis |
| title_short | Impacts of the COVID-19 pandemic on access to HIV and reproductive health care among women living with HIV (WLHIV) in Western Kenya: A mixed methods analysis |
| title_sort | impacts of the covid 19 pandemic on access to hiv and reproductive health care among women living with hiv wlhiv in western kenya a mixed methods analysis |
| topic | COVID-19 family planning (FP) pregnancy HIV antiretroviral (ARV) therapy |
| url | https://www.frontiersin.org/articles/10.3389/fgwh.2022.943641/full |
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