HIV testing services and HIV self-testing programming within emergency care in Kenya: a qualitative study of healthcare personnel to inform enhanced service delivery approaches

Authors

Adam R. Aluisio, Department of Emergency Medicine, Alpert Medical School of Brown University, Providence, RI, USA.
Scarlett J. Bergam, School of Medicine and Health Sciences, George Washington University, Washington, DC, USA.
John Kinuthia, Department of Research & Programs, Kenyatta National Hospital, Nairobi, Kenya.
John Wamutitu Maina, Department of Accident and Emergency, Kenyatta National Hospital, Nairobi, Kenya.
Sankei Pirirei, Department of Accident and Emergency, Kenyatta National Hospital, Nairobi, Kenya.
David Bukusi, HIV Prevention Unit, Kenyatta National Hospital, Nairobi, Kenya.
Harriet Waweru, HIV Prevention Unit, Kenyatta National Hospital, Nairobi, Kenya.
Rose Bosire, Center for Public Health Research, Kenya Medical Research Institute, Nairobi, Kenya.
Josephine Chen, Brown University, Providence, RI, USA.
Daniel K. Ojuka, Department of Surgery, University of Nairobi Faculty of Health Sciences, Nairobi, Kenya.
David A. Katz, Department of Global Health, University of Washington, Seattle, WA, USA.
Carey Farquhar, Department of Global Health, University of Washington, Seattle, WA, USA.
Michael J. Mello, Department of Emergency Medicine, Alpert Medical School of Brown University, Providence, RI, USA.
Kate M. Guthrie, Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA.

Document Type

Journal Article

Publication Date

10-22-2024

Journal

AIDS care

DOI

10.1080/09540121.2024.2414087

Keywords

HIV self-Testing; HIV testing services; Kenya; SDG 10: Reduced inequalities; SDG 3: Good health and well-being; emergency health services; qualitative research

Abstract

In Kenya, persons insufficiently engaged in HIV Testing Services (HTS) are often treated in emergency departments (ED). There are limited data from healthcare workers on ED-HTS. A qualitative study was completed to understand challenges and facilitators for ED-HTS and HIV self-testing (HIVST). Data were collected via six focus groups of healthcare workers. Data were inductively analyzed and mapped to the Capability-Opportunity-Motivation Behavioral Model. Focus groups were completed with 49 healthcare workers: 18 nurses, 15 HIV counselors, 10 physicians and 6 administrators. HTS challenges included staff burdens, resources access, deficiencies in systems integration and illness severity. HTS facilitators included education of healthcare workers and patients, services coordination, and specific follow-up processes. HIVST challenges included accuracy concerns, follow-up barriers and psychosocial risks. HIVST facilitators were patient autonomy and confidentiality, resource utilization and ability to reach higher-risk persons. Mapping to the Capability-Opportunity-Motivation Behavioral Model interventions within the domains of knowledge, decision processes, environmental aspects, social influences and professional identities could support enhanced ED-HTS with integrated HIVST delivery. This study provided insights into challenges and facilitators on ED-HTS and identifies pragmatic approaches to improve healthcare workers' behaviors and abilities to provide services to persons already in contact with healthcare.

APA Citation

Aluisio, Adam R.; Bergam, Scarlett J.; Kinuthia, John; Maina, John Wamutitu; Pirirei, Sankei; Bukusi, David; Waweru, Harriet; Bosire, Rose; Chen, Josephine; Ojuka, Daniel K.; Katz, David A.; Farquhar, Carey; Mello, Michael J.; and Guthrie, Kate M., "HIV testing services and HIV self-testing programming within emergency care in Kenya: a qualitative study of healthcare personnel to inform enhanced service delivery approaches" (2024). GW Authored Works. Paper 5795.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/5795

Department

School of Medicine and Health Sciences Student Works