dc.description.abstract |
Introduction: The 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).
Methods: Data 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.
Results: We 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.
TYPE Original Research
PUBLISHED 12 December 2022
| DOI 10.3389/fgwh.2022.943641
Frontiers in Global Women’s Health 01 frontiersin.org
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.
Discussion: The 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. |
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