Missed opportunities for early HIV diagnosis: critical insights from the stories of Kenyan women living with HIV

Abstract

Early HIV testing is critical for prevention and timely treatment. Missed opportunities for HIV diagnosis can result in unnecessary deaths at a time when access to antiretroviral treatment proves lifesaving. While HIV prevention and treatment research has increased, less research exists on women's experiences with HIV diagnosis, despite the fact that women are most affected. Insights from local women are critical in designing culturally meaningful interventions that thwart missed opportunities for early HIV diagnosis. The purpose of our study was to uncover steps women took to know their HIV diagnosis. Using narrative inquiry methodology informed by postcolonial feminism, we interviewed 40 HIV-positive women in Kenya. Five themes emerged related to uptake of HIV testing for women: (1) spouse's critical illness or death; (2) years of suffering from HIV-related symptoms; (3) sick children; (4) prenatal testing; and (5) personal desire to know one's HIV status. These findings centered on women experiences provide an important basis for health promotion interventions related to HIV prevention, earlier detection, and treatment.

Keywords:

• early HIV diagnosis
• HIV-positive women
• qualitative study
• missed opportunities
• Kenya

Acknowledgements

We are thankful to the women who shared their HIV discovery stories, and we wish to acknowledge Beatrice Mutemi for her efforts in organizing rural women; without whose assistance this study would not have been possible, and we thank Ms Patricia D. Lofton for her assistance in formatting this manuscript for publication. This research was funded in part by National Institutes of Health under Ruth L. Kirschstein National Research Service Award (F31NR 009628) in the National Institute of Nursing Research and by Midwest Nursing Research Society Dissertation Award, and an award from the University of Wisconsin System Institute on Race and Ethnicity.

The authors report no real or perceived vested interests relating to this article (including relationships with pharmaceutical companies, biomedical device manufacturers, grantors, or other entities whose products or services relate to topics covered in this manuscript) that could be construed as conflicts of interest.

Notes

^1. Ĩweto is a woman-to-woman marriage for the purpose of bearing children to the older woman who does not have children. Ĩweto forms relations with men for the purpose of conceiving and bearing children to raise a family for the woman she marries. All the children born by Ĩweto belong to the woman who brought her to the family.