TY - JOUR

T1 - Barriers and facilitators of access to HIV, harm reduction and sexual and reproductive health services by women who inject drugs

T2 - role of community-based outreach and drop-in centers

AU - Ayon, Sylvia

AU - Ndimbii, James

AU - Abdulrahman, Taib

AU - Mlewa, Onesmus

AU - Wang, Bangyuan

AU - Ragi, Allan

AU - Mburu, Gitau

N1 - This is an Accepted Manuscript of an article published by Taylor & Francis in AIDS Care on 25/10/2017, available online: http://www.tandfonline.com/10.1080/09540121.2017.1394965

PY - 2018/5

Y1 - 2018/5

N2 - There is limited data regarding women who inject drugs, and how harm-reduction services can be made more women-centered. This study explored experiences of Kenyan women who inject drugs, with regard to access to HIV, harm reduction and sexual and reproductive health (SRH) services. A total of 45 women who inject drugs and 5 key stakeholders participated in-depth interviews and focus group discussions. Thematic analysis of the data revealed that stigma, long distances, lack of confidentiality, user fees, multiple appointments, drug users’ unfamiliarity with health facilities, disconnect in communication with healthcare providers, and healthcare providers’ lack of understanding of women’s needs were factors that impede women’s access to health services. Community-based services, comprising of outreach and drop-in centers mitigate these barriers by building trust, educating women on their health and rights, linking women to health facilities, sensitizing health providers on the needs of women who inject drugs, and integrating women’s SRH services into community-based harm-reduction outreach. Inclusion of SRH services into community-based harm-reduction activities increased women’s interest and access to harm-reduction interventions. These findings underscore the need to strengthen community-based programming for women who inject drugs, and to integrate SRH services into needle and syringe exchange programs.

AB - There is limited data regarding women who inject drugs, and how harm-reduction services can be made more women-centered. This study explored experiences of Kenyan women who inject drugs, with regard to access to HIV, harm reduction and sexual and reproductive health (SRH) services. A total of 45 women who inject drugs and 5 key stakeholders participated in-depth interviews and focus group discussions. Thematic analysis of the data revealed that stigma, long distances, lack of confidentiality, user fees, multiple appointments, drug users’ unfamiliarity with health facilities, disconnect in communication with healthcare providers, and healthcare providers’ lack of understanding of women’s needs were factors that impede women’s access to health services. Community-based services, comprising of outreach and drop-in centers mitigate these barriers by building trust, educating women on their health and rights, linking women to health facilities, sensitizing health providers on the needs of women who inject drugs, and integrating women’s SRH services into community-based harm-reduction outreach. Inclusion of SRH services into community-based harm-reduction activities increased women’s interest and access to harm-reduction interventions. These findings underscore the need to strengthen community-based programming for women who inject drugs, and to integrate SRH services into needle and syringe exchange programs.

KW - HIV

KW - injecting drug use

KW - women

KW - sexual and reproductive health

KW - integration

U2 - 10.1080/09540121.2017.1394965

DO - 10.1080/09540121.2017.1394965

M3 - Journal article

VL - 30

SP - 480

EP - 487

JO - AIDS Care

JF - AIDS Care

SN - 0954-0121

IS - 4

ER -