Experiences With Safer Conception Services for HIV-Serodiscordant Couples at a Referral Hospital in Nairobi, Kenya
Human immunodeficiency virus-serodiscordant couples are an important source of new HIV infections in Africa. When trying to conceive, uninfected partners may be at high risk of infection if the infected partner is not virally suppressed. Multiple strategies targeting safer conception exist, but thes...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2021-11-01
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| Series: | Frontiers in Reproductive Health |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/frph.2021.693429/full |
| _version_ | 1818841136934944768 |
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| author | Anne Kaggiah Grace Kimemia Hellen Moraa Peter Muiruri John Kinuthia Alison C. Roxby |
| author_facet | Anne Kaggiah Grace Kimemia Hellen Moraa Peter Muiruri John Kinuthia Alison C. Roxby |
| author_sort | Anne Kaggiah |
| collection | DOAJ |
| description | Human immunodeficiency virus-serodiscordant couples are an important source of new HIV infections in Africa. When trying to conceive, uninfected partners may be at high risk of infection if the infected partner is not virally suppressed. Multiple strategies targeting safer conception exist, but these services are limited. However, when services are available and used, serodiscordant couples can be protected from HIV transmission, and safe to have children if desired. To successfully introduce, integrate, promote, and optimize the service delivery of safer conception with HIV care, it is crucial to understand how HIV-serodiscordant couples perceive and experience these services. Further, viral load monitoring can be critical to safer conception, but there is limited literature on how it informs the decision of the partners about conception. This qualitative study describes the knowledge, perceptions, and experiences of both safer conception services and viral load monitoring among 26 HIV-serodiscordant couples seeking safer conception care at a referral hospital in Nairobi, Kenya. In-depth interviews of HIV-serodiscordant couples were conducted from April to July 2017, and transcripts were analyzed to identify the themes central to the experience of safer conception services of couples and viral load monitoring. Serodiscordant couples reported success in using some of the safer conception methods and had positive experiences with healthcare providers. However, despite using the services, some were concerned about HIV transmission to the seronegative partner and baby, while others faced challenges when using pre-exposure prophylaxis (PrEP) and vaginal insemination. Overall, their motivation to have children overcame their concern about HIV transmission, and they welcomed discussions on risk reduction. Moreover, supportive clinic staff was identified as key to facilitating trust in safer conception methods. Furthermore, viral load monitoring was identified as integral to safer conception methods, an emerging theme that requires further evaluation, especially where routine viral load monitoring is not performed. In conclusion, healthcare providers offering safer conception services should build trust with couples, and recognize the need for continual couple counseling to encourage the adoption of safer conception services. |
| first_indexed | 2024-12-19T04:21:17Z |
| format | Article |
| id | doaj.art-a788e80beada40f88fc31ceba9029c30 |
| institution | Directory Open Access Journal |
| issn | 2673-3153 |
| language | English |
| last_indexed | 2024-12-19T04:21:17Z |
| publishDate | 2021-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Reproductive Health |
| spelling | doaj.art-a788e80beada40f88fc31ceba9029c302022-12-21T20:36:09ZengFrontiers Media S.A.Frontiers in Reproductive Health2673-31532021-11-01310.3389/frph.2021.693429693429Experiences With Safer Conception Services for HIV-Serodiscordant Couples at a Referral Hospital in Nairobi, KenyaAnne Kaggiah0Grace Kimemia1Hellen Moraa2Peter Muiruri3John Kinuthia4Alison C. Roxby5Department of Research and Programs, Kenyatta National Hospital, Nairobi, KenyaAfrican Population and Health Research Center, Nairobi, KenyaPediatrics Department, University of Nairobi, Nairobi, KenyaCoEHM Project, Kenyatta National Hospital, Nairobi, KenyaDepartment of Research and Programs, Kenyatta National Hospital, Nairobi, KenyaDepartments of Medicine and Global Health, University of Washington, Seattle, WA, United StatesHuman immunodeficiency virus-serodiscordant couples are an important source of new HIV infections in Africa. When trying to conceive, uninfected partners may be at high risk of infection if the infected partner is not virally suppressed. Multiple strategies targeting safer conception exist, but these services are limited. However, when services are available and used, serodiscordant couples can be protected from HIV transmission, and safe to have children if desired. To successfully introduce, integrate, promote, and optimize the service delivery of safer conception with HIV care, it is crucial to understand how HIV-serodiscordant couples perceive and experience these services. Further, viral load monitoring can be critical to safer conception, but there is limited literature on how it informs the decision of the partners about conception. This qualitative study describes the knowledge, perceptions, and experiences of both safer conception services and viral load monitoring among 26 HIV-serodiscordant couples seeking safer conception care at a referral hospital in Nairobi, Kenya. In-depth interviews of HIV-serodiscordant couples were conducted from April to July 2017, and transcripts were analyzed to identify the themes central to the experience of safer conception services of couples and viral load monitoring. Serodiscordant couples reported success in using some of the safer conception methods and had positive experiences with healthcare providers. However, despite using the services, some were concerned about HIV transmission to the seronegative partner and baby, while others faced challenges when using pre-exposure prophylaxis (PrEP) and vaginal insemination. Overall, their motivation to have children overcame their concern about HIV transmission, and they welcomed discussions on risk reduction. Moreover, supportive clinic staff was identified as key to facilitating trust in safer conception methods. Furthermore, viral load monitoring was identified as integral to safer conception methods, an emerging theme that requires further evaluation, especially where routine viral load monitoring is not performed. In conclusion, healthcare providers offering safer conception services should build trust with couples, and recognize the need for continual couple counseling to encourage the adoption of safer conception services.https://www.frontiersin.org/articles/10.3389/frph.2021.693429/fullHIVserodiscordant couplesafer conceptionHIV viral loadpregnancyKenya |
| spellingShingle | Anne Kaggiah Grace Kimemia Hellen Moraa Peter Muiruri John Kinuthia Alison C. Roxby Experiences With Safer Conception Services for HIV-Serodiscordant Couples at a Referral Hospital in Nairobi, Kenya Frontiers in Reproductive Health HIV serodiscordant couple safer conception HIV viral load pregnancy Kenya |
| title | Experiences With Safer Conception Services for HIV-Serodiscordant Couples at a Referral Hospital in Nairobi, Kenya |
| title_full | Experiences With Safer Conception Services for HIV-Serodiscordant Couples at a Referral Hospital in Nairobi, Kenya |
| title_fullStr | Experiences With Safer Conception Services for HIV-Serodiscordant Couples at a Referral Hospital in Nairobi, Kenya |
| title_full_unstemmed | Experiences With Safer Conception Services for HIV-Serodiscordant Couples at a Referral Hospital in Nairobi, Kenya |
| title_short | Experiences With Safer Conception Services for HIV-Serodiscordant Couples at a Referral Hospital in Nairobi, Kenya |
| title_sort | experiences with safer conception services for hiv serodiscordant couples at a referral hospital in nairobi kenya |
| topic | HIV serodiscordant couple safer conception HIV viral load pregnancy Kenya |
| url | https://www.frontiersin.org/articles/10.3389/frph.2021.693429/full |
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