Utilization of sexual and reproductive health services among young people living with HIV and attending selected HIV clinics in selected sub-counties of Nairobi, Kenya

Nomsa Phiri, Susan Mambo, Careena Otieno Odawa
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Abstract

Background Young people living with HIV in Sub-Saharan Africa account for the largest proportion of the vulnerable population in the world. Kenya has little evidence to showcase the utilization of sexual and reproductive health services among young people living with HIV. Nairobi County has one of the highest HIV burdens among adolescents and youth in the country. Consequently, assessing the factors associated with the utilization of sexual and reproductive health services among young people aged 15–24 years living with HIV motivates this study. Methods A health facility-based cross-sectional study design with convergent parallel mixed methods technique was used. Purposive sampling with predetermined criteria was used to select six high-volume public health facilities in six high-burden sub-counties of Nairobi. A total of 253 participants completed the semi-structured questionnaires on utilization and associated factors.12 purposively selected healthcare workers were in key informant sessions on their perception of young people’s utilization. Stepwise binary logistic regression was used to analyse the quantitative data using Stata version 14. NVivo software was used to code and thematically analyse the data. Results 47 % of the participants had utilized the services. Collection of condoms (45.7%) was the most utilized while treatment of sexually transmitted infections (8.2%) was the least utilized services. Female sex (AOR: 3.60 95%, Cl: 1.67-6.40), increase in age (AOR: 2.27 95%, Cl: 1.1C-4.65), HIV status disclosure to a sexual partner (AOR: 2.00 95%, Cl: 1.11-3.80) and privacy for sexual and reproductive health services at a health facility (AOR: 3.27 95%Cl: 1.42-7.60) were factors significantly associated with utilization. Conclusions Although this vulnerable population has frequent contact with healthcare providers, utilization of sexual and reproductive services is low. Stakeholders are recommended to put more emphasis on behavioural interventions to promote male involvement and HIV disclosure to sexual partners.
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肯尼亚内罗毕部分县感染艾滋病毒并在部分艾滋病毒诊所就诊的年轻人对性健康和生殖健康服务的利用情况
背景撒哈拉以南非洲地区感染艾滋病毒的年轻人在世界易感人群中所占比例最大。肯尼亚几乎没有证据表明感染艾滋病毒的年轻人利用了性健康和生殖健康服务。内罗毕县是该国青少年中艾滋病毒感染率最高的地区之一。因此,对 15-24 岁感染艾滋病毒的年轻人利用性健康和生殖健康服务的相关因素进行评估是本研究的动机。研究方法 采用基于医疗机构的横断面研究设计,并采用聚合平行混合方法技术。按照预先确定的标准进行有目的的抽样,在内罗毕的六个高负担分县选择了六个大容量的公共卫生机构。共有 253 名参与者填写了关于使用情况和相关因素的半结构式问卷。12 名特意挑选的医护人员参加了关键信息提供者会议,了解他们对年轻人使用情况的看法。使用 Stata 14 版对定量数据进行了逐步二元逻辑回归分析。使用 NVivo 软件对数据进行编码和主题分析。结果 47% 的参与者使用过服务。使用率最高的服务是领取安全套(45.7%),使用率最低的服务是治疗性传播感染(8.2%)。女性性别(AOR:3.60 95%,Cl:1.67-6.40)、年龄增长(AOR:2.27 95%,Cl:1.1-4.65)、向性伴侣披露 HIV 感染状况(AOR:2.00 95%,Cl:1.11-3.80)以及在医疗机构获得性健康和生殖健康服务的隐私(AOR:3.27 95%Cl:1.42-7.60)是与使用率显著相关的因素。结论 尽管这一弱势群体与医疗服务提供者接触频繁,但他们对性健康和生殖健康服务的利用率却很低。建议利益相关者更加重视行为干预,促进男性参与并向性伴侣披露艾滋病信息。
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