Experiences With Safer Conception Services for HIV-Serodiscordant Couples at a Referral Hospital in Nairobi, Kenya

Human immunodeficiency virus-serodiscordant couples are an important source of new HIV infections in Africa. When trying to conceive, uninfected partners may be at high risk of infection if the infected partner is not virally suppressed. Multiple strategies targeting safer conception exist, but thes...

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Autores principales:	Anne Kaggiah, Grace Kimemia, Hellen Moraa, Peter Muiruri, John Kinuthia, Alison C. Roxby
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	HIV serodiscordant couple safer conception HIV viral load pregnancy Kenya Reproduction QH471-489 Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/a788e80beada40f88fc31ceba9029c30
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spelling	oai:doaj.org-article:a788e80beada40f88fc31ceba9029c302021-11-04T06:49:21ZExperiences With Safer Conception Services for HIV-Serodiscordant Couples at a Referral Hospital in Nairobi, Kenya2673-315310.3389/frph.2021.693429https://doaj.org/article/a788e80beada40f88fc31ceba9029c302021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/frph.2021.693429/fullhttps://doaj.org/toc/2673-3153Human immunodeficiency virus-serodiscordant couples are an important source of new HIV infections in Africa. When trying to conceive, uninfected partners may be at high risk of infection if the infected partner is not virally suppressed. Multiple strategies targeting safer conception exist, but these services are limited. However, when services are available and used, serodiscordant couples can be protected from HIV transmission, and safe to have children if desired. To successfully introduce, integrate, promote, and optimize the service delivery of safer conception with HIV care, it is crucial to understand how HIV-serodiscordant couples perceive and experience these services. Further, viral load monitoring can be critical to safer conception, but there is limited literature on how it informs the decision of the partners about conception. This qualitative study describes the knowledge, perceptions, and experiences of both safer conception services and viral load monitoring among 26 HIV-serodiscordant couples seeking safer conception care at a referral hospital in Nairobi, Kenya. In-depth interviews of HIV-serodiscordant couples were conducted from April to July 2017, and transcripts were analyzed to identify the themes central to the experience of safer conception services of couples and viral load monitoring. Serodiscordant couples reported success in using some of the safer conception methods and had positive experiences with healthcare providers. However, despite using the services, some were concerned about HIV transmission to the seronegative partner and baby, while others faced challenges when using pre-exposure prophylaxis (PrEP) and vaginal insemination. Overall, their motivation to have children overcame their concern about HIV transmission, and they welcomed discussions on risk reduction. Moreover, supportive clinic staff was identified as key to facilitating trust in safer conception methods. Furthermore, viral load monitoring was identified as integral to safer conception methods, an emerging theme that requires further evaluation, especially where routine viral load monitoring is not performed. In conclusion, healthcare providers offering safer conception services should build trust with couples, and recognize the need for continual couple counseling to encourage the adoption of safer conception services.Anne KaggiahGrace KimemiaHellen MoraaPeter MuiruriJohn KinuthiaAlison C. RoxbyFrontiers Media S.A.articleHIVserodiscordant couplesafer conceptionHIV viral loadpregnancyKenyaReproductionQH471-489Medicine (General)R5-920ENFrontiers in Reproductive Health, Vol 3 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	HIV serodiscordant couple safer conception HIV viral load pregnancy Kenya Reproduction QH471-489 Medicine (General) R5-920
spellingShingle	HIV serodiscordant couple safer conception HIV viral load pregnancy Kenya Reproduction QH471-489 Medicine (General) R5-920 Anne Kaggiah Grace Kimemia Hellen Moraa Peter Muiruri John Kinuthia Alison C. Roxby Experiences With Safer Conception Services for HIV-Serodiscordant Couples at a Referral Hospital in Nairobi, Kenya
description	Human immunodeficiency virus-serodiscordant couples are an important source of new HIV infections in Africa. When trying to conceive, uninfected partners may be at high risk of infection if the infected partner is not virally suppressed. Multiple strategies targeting safer conception exist, but these services are limited. However, when services are available and used, serodiscordant couples can be protected from HIV transmission, and safe to have children if desired. To successfully introduce, integrate, promote, and optimize the service delivery of safer conception with HIV care, it is crucial to understand how HIV-serodiscordant couples perceive and experience these services. Further, viral load monitoring can be critical to safer conception, but there is limited literature on how it informs the decision of the partners about conception. This qualitative study describes the knowledge, perceptions, and experiences of both safer conception services and viral load monitoring among 26 HIV-serodiscordant couples seeking safer conception care at a referral hospital in Nairobi, Kenya. In-depth interviews of HIV-serodiscordant couples were conducted from April to July 2017, and transcripts were analyzed to identify the themes central to the experience of safer conception services of couples and viral load monitoring. Serodiscordant couples reported success in using some of the safer conception methods and had positive experiences with healthcare providers. However, despite using the services, some were concerned about HIV transmission to the seronegative partner and baby, while others faced challenges when using pre-exposure prophylaxis (PrEP) and vaginal insemination. Overall, their motivation to have children overcame their concern about HIV transmission, and they welcomed discussions on risk reduction. Moreover, supportive clinic staff was identified as key to facilitating trust in safer conception methods. Furthermore, viral load monitoring was identified as integral to safer conception methods, an emerging theme that requires further evaluation, especially where routine viral load monitoring is not performed. In conclusion, healthcare providers offering safer conception services should build trust with couples, and recognize the need for continual couple counseling to encourage the adoption of safer conception services.
format	article
author	Anne Kaggiah Grace Kimemia Hellen Moraa Peter Muiruri John Kinuthia Alison C. Roxby
author_facet	Anne Kaggiah Grace Kimemia Hellen Moraa Peter Muiruri John Kinuthia Alison C. Roxby
author_sort	Anne Kaggiah
title	Experiences With Safer Conception Services for HIV-Serodiscordant Couples at a Referral Hospital in Nairobi, Kenya
title_short	Experiences With Safer Conception Services for HIV-Serodiscordant Couples at a Referral Hospital in Nairobi, Kenya
title_full	Experiences With Safer Conception Services for HIV-Serodiscordant Couples at a Referral Hospital in Nairobi, Kenya
title_fullStr	Experiences With Safer Conception Services for HIV-Serodiscordant Couples at a Referral Hospital in Nairobi, Kenya
title_full_unstemmed	Experiences With Safer Conception Services for HIV-Serodiscordant Couples at a Referral Hospital in Nairobi, Kenya
title_sort	experiences with safer conception services for hiv-serodiscordant couples at a referral hospital in nairobi, kenya
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/a788e80beada40f88fc31ceba9029c30
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Experiences With Safer Conception Services for HIV-Serodiscordant Couples at a Referral Hospital in Nairobi, Kenya

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