Health Provider Views on Improving Antiretroviral Therapy Adherence Among Men Who Have Sex with Men in Coastal Kenya

• DOI: 10.1089/apc.2016.0213
• Publication Date: 2017-02-22T17:01:12Z
• Authors: Murugi Micheni; Bernadette K. Kombo; Andrew Secor; Jane M. Simoni; Don Operario; Elise M. van der ...; Peter Mugo; Jennifer Kanungi; Eduard J. Sanders; Susan M. Graham
• Keywords: Stigma; Facilitator; Social stigma

HIV-positive Kenyan men who have sex with (MSM) are a highly stigmatized group facing barriers to care engagement and antiretroviral therapy (ART) adherence. Because providers' views important in improving outcomes, we sought the perspective of those serving MSM patients on how optimize ART adherence setting where same-sex behavior is criminalized. We conducted 4 focus discussions total 29 healthcare workers (HCWs) experienced providing HIV MSM. The semistructured, open-ended topic guide used was based an access-information-motivation-proximal cues model adherence, added trust providers, stigma, discrimination. Detailed facilitator notes transcripts were translated into English reviewed for common themes. HCW identified challenges that similar general population, including HIV-related stigma lack disclosure. In addition, HCWs noted specific MSM, such as access MSM-friendly health services, economic social due difficult relationships discrimination at clinic community. recommended staff sensitivity training, use trained peer navigators, reduction community interventions might improve outcomes Despite noting MSM-specific barriers, strategies rights-constrained settings merit future research attention. Most likely, multilevel incorporating both individual structural factors will be necessary.