Factors influencing access of HIV and sexual and reproductive health services among adolescent key populations in Kenya

Abstract

Objectives The objective of this study is to identify enablers and barriers in access of HIV and sexual reproductive health (SRH) services among adolescent key populations (KP) in Kenya. Methods A cross-sectional study using qualitative methods was conducted between October 2015 and April 2016. A total of 9 focus group discussions and 18 in-depth interviews were conducted with 108 adolescent KPs in Mombasa, Kisumu and Nairobi Counties of Kenya. Data were recorded digitally, translated, transcribed and coded in NVivo10 prior to analysis. Results Adolescent KPs preferred to access services in private health due to increased confidentiality, limited stigma and discrimination, access to adequate amount of condoms, friendly and fast-tracked services. Negative health provider attitudes made adolescent KPs dislike accessing health care in public health facilities. There was a lack of adolescent key population's policies and guidelines on HIV and SRH. Conclusions The study has demonstrated existing enablers and barriers to provision of HIV/SRH services for an at-risk population for which limited data exist. The results provide a basis for program redesign involving the adolescent KPs to minimize barriers for access to HIV/SRH services. Keywords Adolescents Á Adolescent key populations Á People who inject drugs Á Sex workers Á Men who have sex with men (MSM) This article is part of the special issue ''Sexual and reproductive health of young people-Focus Africa''. The Rudolf Geigy Foundation (Basel, Switzerland) funded the open access publication of this article.

Women who have sex with women’s experiences with healthcare system in low-income countries: qualitative findings from Dar-es-Salaam, Tanzania

“…These discriminative incidents toward the WSW have also been reported in past research in Tanzania [8]. The WSW behavior is frowned upon by some health care providers, which many cause negative experiences during health care utilization by WSW [8], [10]. Negative experiences may eventually precipitate sub-optimal utilization of services, non-utilization of services, and sometimes self-medication.…”

“…A study in Tanzania indicated stigma, discrimination, shame, mistreatment, and lack of confidentiality as factors for nondisclosure of sexual orientation to health providers by MSM during care, a decision that might have interfered with proper treatment [9]. Similar studies in East Africa and across the world have reported similar barriers to health care access among key population [10], [11].…”

“…Health and health care access are fundamental human rights for everyone. Many studies have reported lower access to health services by sexual minorities [7]- [10]. Barriers to access include stigma, discrimination, and lack of money, among others [7], [10], [11].…”

“…Many studies have reported lower access to health services by sexual minorities [7]- [10]. Barriers to access include stigma, discrimination, and lack of money, among others [7], [10], [11]. For example, findings from a research study on barriers to health care access among MSM in Tanzania reported lack of money as the primary factor for non-use of health care [9].…”

Study on Influencing Factors to HIV Health Services Among MSM: Based on Andersen Behavioral Model

“…In health services, the priority groups often focus on: adolescents [10], mothers and children [11], migrants [12], female sex workers [13] , etc. MSM, as a special population, has been largely ignored by health service projects [9].…”