Integration of HIV Care with Primary Health Care Services: Effect on Patient Satisfaction and Stigma in Rural Kenya
HIV departments within Kenyan health facilities are usually better staffed and equipped than departments offering non-HIV services. Integration of HIV services into primary care may address this issue of skewed resource allocation. Between 2008 and 2010, we piloted a system of integrating HIV servic...
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| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2013-01-01
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| Series: | AIDS Research and Treatment |
| Online Access: | http://dx.doi.org/10.1155/2013/485715 |
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| author | Thomas A. Odeny Jeremy Penner Jayne Lewis-Kulzer Hannah H. Leslie Starley B. Shade Walter Adero Jackson Kioko Craig R. Cohen Elizabeth A. Bukusi |
| author_facet | Thomas A. Odeny Jeremy Penner Jayne Lewis-Kulzer Hannah H. Leslie Starley B. Shade Walter Adero Jackson Kioko Craig R. Cohen Elizabeth A. Bukusi |
| author_sort | Thomas A. Odeny |
| collection | DOAJ |
| description | HIV departments within Kenyan health facilities are usually better staffed and equipped than departments offering non-HIV services. Integration of HIV services into primary care may address this issue of skewed resource allocation. Between 2008 and 2010, we piloted a system of integrating HIV services into primary care in rural Kenya. Before integration, we conducted a survey among returning adults ≥18-year old attending the HIV clinic. We then integrated HIV and primary care services. Three and twelve months after integration, we administered the same questionnaires to a sample of returning adults attending the integrated clinic. Changes in patient responses were assessed using truncated linear regression and logistic regression. At 12 months after integration, respondents were more likely to be satisfied with reception services (adjusted odds ratio, aOR 2.71, 95% CI 1.32–5.56), HIV education (aOR 3.28, 95% CI 1.92–6.83), and wait time (aOR 1.97 95% CI 1.03–3.76). Men's comfort with receiving care at an integrated clinic did not change (aOR = 0.46 95% CI 0.06–3.86). Women were more likely to express discomfort after integration (aOR 3.37 95% CI 1.33–8.52). Integration of HIV services into primary care services was associated with significant increases in patient satisfaction in certain domains, with no negative effect on satisfaction. |
| format | Article |
| id | doaj-art-8c04aa5848fa4aa1bdc4b6c2bd74e6b8 |
| institution | Kabale University |
| issn | 2090-1240 2090-1259 |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | AIDS Research and Treatment |
| spelling | doaj-art-8c04aa5848fa4aa1bdc4b6c2bd74e6b82025-02-03T05:59:51ZengWileyAIDS Research and Treatment2090-12402090-12592013-01-01201310.1155/2013/485715485715Integration of HIV Care with Primary Health Care Services: Effect on Patient Satisfaction and Stigma in Rural KenyaThomas A. Odeny0Jeremy Penner1Jayne Lewis-Kulzer2Hannah H. Leslie3Starley B. Shade4Walter Adero5Jackson Kioko6Craig R. Cohen7Elizabeth A. Bukusi8Family AIDS Care and Education Services, Kisumu, KenyaFamily AIDS Care and Education Services, Kisumu, KenyaFamily AIDS Care and Education Services, Kisumu, KenyaCenter for AIDS Prevention Studies, University of California San Francisco, San Francisco, CA, USACenter for AIDS Prevention Studies, University of California San Francisco, San Francisco, CA, USAFamily AIDS Care and Education Services, Kisumu, KenyaMinistry of Public Health and Sanitation, Government of Kenya, Kisumu, KenyaFamily AIDS Care and Education Services, Kisumu, KenyaFamily AIDS Care and Education Services, Kisumu, KenyaHIV departments within Kenyan health facilities are usually better staffed and equipped than departments offering non-HIV services. Integration of HIV services into primary care may address this issue of skewed resource allocation. Between 2008 and 2010, we piloted a system of integrating HIV services into primary care in rural Kenya. Before integration, we conducted a survey among returning adults ≥18-year old attending the HIV clinic. We then integrated HIV and primary care services. Three and twelve months after integration, we administered the same questionnaires to a sample of returning adults attending the integrated clinic. Changes in patient responses were assessed using truncated linear regression and logistic regression. At 12 months after integration, respondents were more likely to be satisfied with reception services (adjusted odds ratio, aOR 2.71, 95% CI 1.32–5.56), HIV education (aOR 3.28, 95% CI 1.92–6.83), and wait time (aOR 1.97 95% CI 1.03–3.76). Men's comfort with receiving care at an integrated clinic did not change (aOR = 0.46 95% CI 0.06–3.86). Women were more likely to express discomfort after integration (aOR 3.37 95% CI 1.33–8.52). Integration of HIV services into primary care services was associated with significant increases in patient satisfaction in certain domains, with no negative effect on satisfaction.http://dx.doi.org/10.1155/2013/485715 |
| spellingShingle | Thomas A. Odeny Jeremy Penner Jayne Lewis-Kulzer Hannah H. Leslie Starley B. Shade Walter Adero Jackson Kioko Craig R. Cohen Elizabeth A. Bukusi Integration of HIV Care with Primary Health Care Services: Effect on Patient Satisfaction and Stigma in Rural Kenya AIDS Research and Treatment |
| title | Integration of HIV Care with Primary Health Care Services: Effect on Patient Satisfaction and Stigma in Rural Kenya |
| title_full | Integration of HIV Care with Primary Health Care Services: Effect on Patient Satisfaction and Stigma in Rural Kenya |
| title_fullStr | Integration of HIV Care with Primary Health Care Services: Effect on Patient Satisfaction and Stigma in Rural Kenya |
| title_full_unstemmed | Integration of HIV Care with Primary Health Care Services: Effect on Patient Satisfaction and Stigma in Rural Kenya |
| title_short | Integration of HIV Care with Primary Health Care Services: Effect on Patient Satisfaction and Stigma in Rural Kenya |
| title_sort | integration of hiv care with primary health care services effect on patient satisfaction and stigma in rural kenya |
| url | http://dx.doi.org/10.1155/2013/485715 |
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