| dc.description.abstract | The burden of HIV/AIDS in Baringo County is highest among Adults (>18 years), with
over 40% of hospital beds occupied by HIV-related illnesses. Despite the majority of
HIV/AIDS clients being enrolled in care programs, care interruptions (dropouts) and loss
of follow-up remain major challenges with unclear reasons for defaulting. Therefore, this
study aimed to investigate HIV/AIDS care and support service utilization among HIV
infected adults in Baringo County, examining the relationship between client uptake, attitudes, accessibility and utilization of services. It also examined the impact of stigma
and discrimination on service utilization. The study was conducted in Baringo County
among HIV-infected adults enrolled in Comprehensive care centers using an analytical
cross-sectional study design. A total of 580 study participants were randomly recruited u
ng Fisher et al.'s (1998) formula from four purposefully selected sub-counties. Besides, an
interviewer-administered questionnaire was used to collect data. Quantitative data was
analyzed using Statistical Package for Social Sciences (SPSS) version 27 with Inferential
statistics (Univariate and bivariate) analyses conducted at a p = 0.05 significance level.
Whereas, qualitative data was transcribed and analyzed thematically. Ethical
clearance was sought from the Institutional Scientific and Ethics Review Committee at
Masinde Muliro University (Ref No: MMU/COR: 403012 Vol 6 (01), the National
Commission for Science, Technology and Innovation (NACOSTI) (Ref No: 963149), the
Baringo County Government Department of Health (REF: BCG/HS/RES/01/VOL.1/07),
and informed consent from participants. A total of 519 (89.5%) out of a sample size of 580
took part in the study. The Study found 50.7% HIV care uptake, with 80% deterred by a
lack of knowledge and high transportation costs (72.3%). The majority of participants
(90.6%) had positive attitudes towards HIV care and support services, but utilization was
unfavorable due to low knowledge of available services (p = 0.001), fear of ARV drug use
when the spouse is watching (p< 0.0001), and long distances to clinics (p 0.0001).
Besides, statistically significant factors affecting the accessibility of clinic services were
difficulty obtaining services (p < 0.0001), and long distance to clinics (p 0.0001), with
clients unlikely to use them. HIV-related stigma and discrimination were found to
negatively impact participants' utilization of services, with participants feeling ashamed to
attend clinics (p<0.0001) and others judging them when seen attending clinics (p<0.0001),
leading to low utilization rates with higher odds found in each case. In conclusion, the
study found 50.7% of HIV-infected adults in Baringo County consistently utilize HIV care
and support services, with higher education, community support services, counseling, and
family support promoting utilization of services. However, factors like low
socioeconomic status, long distances, high travel costs, and poor medication perception
were associated with poor attitudes towards utilisation of services. Additionally, location
optimization and clinic opening on holidays and weekends improve accessibility.
Whereas, PLHIV were found to internalize the stigma and bigotry they face, contributing
to a negative self-image and lower levels of utilization. The study recommends to the
MOH increase HIV/AIDS care utilization through decentralization of services to the
community or low-tier facilities, stigma reduction, integration of HIV care with other
services, and scaling up services in under-resourced areas. | en_US |
