The Role of Gender in Patient-Provider Relationships: A Qualitative Analysis of HIV Care Providers in Western Kenya with Implications for Retention in Care.
Gender
HIV
Kenya
Patient–provider relationship
Retention
Journal
AIDS and behavior
ISSN: 1573-3254
Titre abrégé: AIDS Behav
Pays: United States
ID NLM: 9712133
Informations de publication
Date de publication:
Feb 2019
Feb 2019
Historique:
pubmed:
1
9
2018
medline:
11
4
2019
entrez:
1
9
2018
Statut:
ppublish
Résumé
The disproportionate burden of HIV among women in sub-Saharan Africa reflects underlying gender inequities, which also impact patient-provider relationships, a key component to retention in HIV care. This study explored how gender shaped the patient-provider relationship and consequently, retention in HIV care in western Kenya. We recruited and consented 60 HIV care providers from three facilities in western Kenya affiliated with the Academic Model Providing Access to Healthcare (AMPATH). Trained research assistants conducted and audio recorded 1-h interviews in English or Swahili. Data were transcribed and analyzed in NVivo using inductive thematic analysis. Gender constructs, as culturally defined, emerged as an important barrier negatively impacting the patient-provider relationship through three main domains: (1) challenges establishing clear roles and sharing power due to conflicting gender versus patient/provider identities, (2) provider frustration over suboptimal patient adherence resulting from gender-influenced contextual barriers, and (3) negative provider perceptions shaped by differing male and female approaches to communication. Programmatic components addressing gender inequities in the health care setting are urgently needed to effectively leverage the patient-provider relationship and fully promote long-term adherence and retention in HIV care.
Identifiants
pubmed: 30168005
doi: 10.1007/s10461-018-2265-4
pii: 10.1007/s10461-018-2265-4
pmc: PMC6368874
mid: NIHMS1505457
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
395-405Subventions
Organisme : NIMH NIH HHS
ID : K01 MH099966
Pays : United States
Organisme : NIGMS NIH HHS
ID : U54 GM115677
Pays : United States
Organisme : National Institute of Mental Health
ID : K01MH099966
Organisme : United States Agency for International Development
ID : USAID-AMPATH Partnership
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