Academic Journal
View in EDS
HTML Full Text

Barriers and facilitators of HIV and hepatitis C care among people who inject drugs in Nairobi, Kenya: a qualitative study with peer educators.

Bibliographic Details
Title: Barriers and facilitators of HIV and hepatitis C care among people who inject drugs in Nairobi, Kenya: a qualitative study with peer educators.
Authors: Ludwig-Barron, Natasha T.1,2 (AUTHOR) nludwig@uw.edu, Guthrie, Brandon L.1,2 (AUTHOR), Mbogo, Loice3 (AUTHOR), Bukusi, David4 (AUTHOR), Sinkele, William5 (AUTHOR), Gitau, Esther5 (AUTHOR), Farquhar, Carey1,2,6 (AUTHOR), Monroe-Wise, Aliza2,6 (AUTHOR)
Source: Harm Reduction Journal. 12/18/2021, Vol. 18 Issue 1, p1-14. 14p.
Subject Terms: *HEPATITIS C, *HIV, *RURAL health services, *VIOLENCE prevention, *EDUCATORS, *QUALITATIVE research, *SOCIAL isolation
Geographic Terms: NAIROBI (Kenya), KENYA
Abstract: Background: In Kenya, people who inject drugs (PWID) are disproportionately affected by HIV and hepatitis C (HCV) epidemics, including HIV-HCV coinfections; however, few have assessed factors affecting their access to and engagement in care through the lens of community-embedded, peer educators. This qualitative study leverages the personal and professional experiences of peer educators to help identify HIV and HCV barriers and facilitators to care among PWID in Nairobi, including resource recommendations to improve service uptake. Methods: We recruited peer educators from two harm reduction facilities in Nairobi, Kenya, using random and purposive sampling techniques. Semi-structured interviews explored circumstances surrounding HIV and HCV service access, prevention education and resource recommendations. A thematic analysis was conducted using the Modified Social Ecological Model (MSEM) as an underlying framework, with illustrative quotes highlighting emergent themes. Results: Twenty peer educators participated, including six women, with 2-months to 6-years of harm reduction service. Barriers to HIV and HCV care were organized by (a) individual-level themes including the competing needs of addiction and misinterpreted symptoms; (b) social network-level themes including social isolation and drug dealer interactions; (c) community-level themes including transportation, mental and rural healthcare services, and limited HCV resources; and (d) policy-level themes including nonintegrated health services, clinical administration, and law enforcement. Stigma, an overarching barrier, was highlighted throughout the MSEM. Facilitators to HIV and HCV care were comprised of (a) individual-level themes including concurrent care, personal reflections, and religious beliefs; (b) social network-level themes including community recommendations, navigation services, family commitment, and employer support; (c) community-level themes including quality services, peer support, and outreach; and (d) policy-level themes including integrated health services and medicalized approaches within law enforcement. Participant resource recommendations include (i) additional medical, social and ancillary support services, (ii) national strategies to address stigma and violence and (iii) HCV prevention education. Conclusions: Peer educators provided intimate knowledge of PWID barriers and facilitators to HIV and HCV care, described at each level of the MSEM, and should be given careful consideration when developing future initiatives. Recommendations emphasized policy and community-level interventions including educational campaigns and program suggestions to supplement existing HIV and HCV services. [ABSTRACT FROM AUTHOR]
Copyright of Harm Reduction Journal is the property of BioMed Central and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Academic Search Complete
Full text is not displayed to guests.
FullText Links:
  – Type: pdflink
Text:
  Availability: 1
CustomLinks:
  – Url: https://resolver.ebsco.com/c/xy5jbn/result?sid=EBSCO:a9h&genre=article&issn=14777517&ISBN=&volume=18&issue=1&date=20211218&spage=1&pages=1-14&title=Harm Reduction Journal&atitle=Barriers%20and%20facilitators%20of%20HIV%20and%20hepatitis%20C%20care%20among%20people%20who%20inject%20drugs%20in%20Nairobi%2C%20Kenya%3A%20a%20qualitative%20study%20with%20peer%20educators.&aulast=Ludwig-Barron%2C%20Natasha%20T.&id=DOI:10.1186/s12954-021-00580-7
    Name: Full Text Finder (for New FTF UI) (s8985755)
    Category: fullText
    Text: Find It @ SCU Libraries
    MouseOverText: Find It @ SCU Libraries
Header DbId: a9h
DbLabel: Academic Search Complete
An: 154196241
AccessLevel: 6
PubType: Academic Journal
PubTypeId: academicJournal
PreciseRelevancyScore: 0
IllustrationInfo
Items – Name: Title
  Label: Title
  Group: Ti
  Data: Barriers and facilitators of HIV and hepatitis C care among people who inject drugs in Nairobi, Kenya: a qualitative study with peer educators.
– Name: Author
  Label: Authors
  Group: Au
  Data: <searchLink fieldCode="AR" term="%22Ludwig-Barron%2C+Natasha+T%2E%22">Ludwig-Barron, Natasha T.</searchLink><relatesTo>1,2</relatesTo> (AUTHOR)<i> nludwig@uw.edu</i><br /><searchLink fieldCode="AR" term="%22Guthrie%2C+Brandon+L%2E%22">Guthrie, Brandon L.</searchLink><relatesTo>1,2</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Mbogo%2C+Loice%22">Mbogo, Loice</searchLink><relatesTo>3</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Bukusi%2C+David%22">Bukusi, David</searchLink><relatesTo>4</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Sinkele%2C+William%22">Sinkele, William</searchLink><relatesTo>5</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Gitau%2C+Esther%22">Gitau, Esther</searchLink><relatesTo>5</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Farquhar%2C+Carey%22">Farquhar, Carey</searchLink><relatesTo>1,2,6</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Monroe-Wise%2C+Aliza%22">Monroe-Wise, Aliza</searchLink><relatesTo>2,6</relatesTo> (AUTHOR)
– Name: TitleSource
  Label: Source
  Group: Src
  Data: <searchLink fieldCode="JN" term="%22Harm+Reduction+Journal%22">Harm Reduction Journal</searchLink>. 12/18/2021, Vol. 18 Issue 1, p1-14. 14p.
– Name: Subject
  Label: Subject Terms
  Group: Su
  Data: *<searchLink fieldCode="DE" term="%22HEPATITIS+C%22">HEPATITIS C</searchLink><br />*<searchLink fieldCode="DE" term="%22HIV%22">HIV</searchLink><br />*<searchLink fieldCode="DE" term="%22RURAL+health+services%22">RURAL health services</searchLink><br />*<searchLink fieldCode="DE" term="%22VIOLENCE+prevention%22">VIOLENCE prevention</searchLink><br />*<searchLink fieldCode="DE" term="%22EDUCATORS%22">EDUCATORS</searchLink><br />*<searchLink fieldCode="DE" term="%22QUALITATIVE+research%22">QUALITATIVE research</searchLink><br />*<searchLink fieldCode="DE" term="%22SOCIAL+isolation%22">SOCIAL isolation</searchLink>
– Name: SubjectGeographic
  Label: Geographic Terms
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22NAIROBI+%28Kenya%29%22">NAIROBI (Kenya)</searchLink><br /><searchLink fieldCode="DE" term="%22KENYA%22">KENYA</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Background: In Kenya, people who inject drugs (PWID) are disproportionately affected by HIV and hepatitis C (HCV) epidemics, including HIV-HCV coinfections; however, few have assessed factors affecting their access to and engagement in care through the lens of community-embedded, peer educators. This qualitative study leverages the personal and professional experiences of peer educators to help identify HIV and HCV barriers and facilitators to care among PWID in Nairobi, including resource recommendations to improve service uptake. Methods: We recruited peer educators from two harm reduction facilities in Nairobi, Kenya, using random and purposive sampling techniques. Semi-structured interviews explored circumstances surrounding HIV and HCV service access, prevention education and resource recommendations. A thematic analysis was conducted using the Modified Social Ecological Model (MSEM) as an underlying framework, with illustrative quotes highlighting emergent themes. Results: Twenty peer educators participated, including six women, with 2-months to 6-years of harm reduction service. Barriers to HIV and HCV care were organized by (a) individual-level themes including the competing needs of addiction and misinterpreted symptoms; (b) social network-level themes including social isolation and drug dealer interactions; (c) community-level themes including transportation, mental and rural healthcare services, and limited HCV resources; and (d) policy-level themes including nonintegrated health services, clinical administration, and law enforcement. Stigma, an overarching barrier, was highlighted throughout the MSEM. Facilitators to HIV and HCV care were comprised of (a) individual-level themes including concurrent care, personal reflections, and religious beliefs; (b) social network-level themes including community recommendations, navigation services, family commitment, and employer support; (c) community-level themes including quality services, peer support, and outreach; and (d) policy-level themes including integrated health services and medicalized approaches within law enforcement. Participant resource recommendations include (i) additional medical, social and ancillary support services, (ii) national strategies to address stigma and violence and (iii) HCV prevention education. Conclusions: Peer educators provided intimate knowledge of PWID barriers and facilitators to HIV and HCV care, described at each level of the MSEM, and should be given careful consideration when developing future initiatives. Recommendations emphasized policy and community-level interventions including educational campaigns and program suggestions to supplement existing HIV and HCV services. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: <i>Copyright of Harm Reduction Journal is the property of BioMed Central and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
PLink https://login.libproxy.scu.edu/login?url=https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&scope=site&db=a9h&AN=154196241
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1186/s12954-021-00580-7
    Languages:
      – Code: eng
        Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 14
        StartPage: 1
    Subjects:
      – SubjectFull: NAIROBI (Kenya)
        Type: general
      – SubjectFull: KENYA
        Type: general
      – SubjectFull: HEPATITIS C
        Type: general
      – SubjectFull: HIV
        Type: general
      – SubjectFull: RURAL health services
        Type: general
      – SubjectFull: VIOLENCE prevention
        Type: general
      – SubjectFull: EDUCATORS
        Type: general
      – SubjectFull: QUALITATIVE research
        Type: general
      – SubjectFull: SOCIAL isolation
        Type: general
    Titles:
      – TitleFull: Barriers and facilitators of HIV and hepatitis C care among people who inject drugs in Nairobi, Kenya: a qualitative study with peer educators.
        Type: main
  BibRelationships:
    HasContributorRelationships:
      – PersonEntity:
          Name:
            NameFull: Ludwig-Barron, Natasha T.
      – PersonEntity:
          Name:
            NameFull: Guthrie, Brandon L.
      – PersonEntity:
          Name:
            NameFull: Mbogo, Loice
      – PersonEntity:
          Name:
            NameFull: Bukusi, David
      – PersonEntity:
          Name:
            NameFull: Sinkele, William
      – PersonEntity:
          Name:
            NameFull: Gitau, Esther
      – PersonEntity:
          Name:
            NameFull: Farquhar, Carey
      – PersonEntity:
          Name:
            NameFull: Monroe-Wise, Aliza
    IsPartOfRelationships:
      – BibEntity:
          Dates:
            – D: 18
              M: 12
              Text: 12/18/2021
              Type: published
              Y: 2021
          Identifiers:
            – Type: issn-print
              Value: 14777517
          Numbering:
            – Type: volume
              Value: 18
            – Type: issue
              Value: 1
          Titles:
            – TitleFull: Harm Reduction Journal
              Type: main
ResultId 1