Effects of Stigma on Uptake of Antiretroviral Therapy Among Women Attending Prevention of Mother-to-child Transmission Clinics in Rachuonyo North Sub-county, Kenya
HIV-related stigma persist as major obstacle to an effective HIV response in all parts of the world, with national surveys finding that discriminatory treatment of people living with HIV remains common in multiple facets of life, including access to health care. HIV and AIDS related stigma may impede uptake of antiretroviral therapy among women in developing countries thus undermining global efforts towards achieving AIDS free generation.Rachuonyo North Sub County is mostly devastated with HIV/AIDS pandemic and the effect of HIV stigma on uptake of ART has been poorly understood. The purpose of the study was to investigate effects of stigma on uptake of antiretroviral therapy among women attending PMTCT clinic in Rachuonyo North Sub County, Kenya. The research objectives were to establish the influence of enacted stigma, anticipated stigma, perceived community stigma and self-stigma on uptake of ART. The study was anchored on theoretical framework postulated by Erving Gofman in 1963 and it employed cross sectional descriptive study design method where Rachuonyo North Sub County was stratified into two divisions and three facilities in each division was purposively selected from each division having met a pre-defined criteria. Semi-structured questionnaires for women visiting the PMTCT clinic and Key Informant Interview guide for health officer in-charge of PMTCT was used to collect data. A sample size of 299 women was established; however 280 women successfully returned their questionnaires. Validity of the instruments was appraised through pilot testing and reliability was tested through a pilot study. The study established that enacted stigma influenced ART uptake by causing 160 (65%) to stop taking anti retroviral drugs, anticipated stigma influenced ART uptake by causing 177(63%) women to stop taking Antiretrovirals, consequently perceived community stigma did influence ART uptake by causing 168(60%) respondents to stop taking antiretroviral drugs and self stigma led to stoppage of antiretroviral drugs among 184(66%) women. The study concluded that enacted stigma, anticipated stigma, perceived community stigma and self-stigma impede ART uptake and should be addressed by enforcing specific stigma reduction strategies to improve ART uptake and thereby increase quality of maternal health. The study findings may be useful to County health officers and other key stakeholders in health sector to improve ART uptake.
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