Abstract:
Background and Objective: Understanding the preferences of women living with HIV (WLH) for the prevention
of mother-to-child HIV transmission (PMTCT) services is important to ensure such services are person-centered.
Methods: From April to December 2022, we surveyed pregnant and postpartum WLH enrolled at five health
facilities in western Kenya to understand their preferences for PMTCT services. WLH were stratified based on
the timing of HIV diagnosis: known HIV-positive (KHP; before antenatal clinic [ANC] enrollment), newly HIVpositive (NHP; on/after ANC enrollment). Multivariable logistic regression was used to determine associations
between various service preferences and NHP (vs. KHP) status, controlling for age, facility, gravidity, retention
status, and pregnancy status.
Results: Among 250 participants (median age 31 years, 31% NHP, 69% KHP), 93% preferred integrated versus
non-integrated HIV and maternal-child health (MCH) services; 37% preferred male partners attend at least one
ANC appointment (vs. no attendance/no preference); 54% preferred support groups (vs. no groups; 96% preferred
facility – over community-based groups); and, preferences for groups was lower among NHP (42%) versus KHP
(60%). NHP had lower odds of preferring support groups versus KHP (aOR 0.45, 95% CI 0.25–0.82), but not the
other services.
Conclusion and Global Health Implications: Integrated services were highly preferred by WLH, supporting the
current PMTCT service model in Kenya. Further research is needed to explore the implementation of facilitybased support groups for WLH as well as the reasons underlying women’s preferences.
