The Role of Gender in Patient-Provider Relationships: A Qualitative Analysis of HIV Care Providers in Western Kenya with Implications for Retention in Care.

Journal: AIDS and behavior

Volume: 23

Issue: 2

Year of Publication: 2019

Affiliated Institutions:  Brown University School of Public Health, Providence, RI, USA. Jennifer_knight@alumni.brown.edu. School of Medicine, Moi University College of Health Sciences, Eldoret, Kenya. Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya. Brown University School of Public Health, Providence, RI, USA.

Abstract summary 

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.

Authors & Co-authors:  Knight Wachira Kafu Braitstein Wilson Harrison Owino Akinyi Koech Genberg

Study Outcome 

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Statistics
Citations :  Reddy V ST, Rispel L, editor. From Social Silence to Social Science: Same-Sex Sexuality, HIV&AIDS and Gender in South Africa. 2009.
Authors :  10
Identifiers
Doi : 10.1007/s10461-018-2265-4
SSN : 1573-3254
Study Population
Male,Women,Female
Mesh Terms
Adult
Other Terms
Gender;HIV;Kenya;Patient–provider relationship;Retention
Study Design
Study Approach
Country of Study
Kenya
Publication Country
United States