How Does Women's Mobility Affect Their Engagement and Retention in HIV Care and Treatment Programs in Kenya? An Exploratory Study

Carol S. Camlin, University of California, San Francisco

This study explored barriers to engagement and retention in HIV antiretroviral therapy (ART) programs faced by HIV-infected migrant and highly mobile women in a high HIV prevalence area of Kenya(1,2). Kenya is rapidly expanding its ART programs, but recent studies of patient retention reported rates ranging between 64% and 81% after one year(3). Few studies have explored how mobility affects the ability of HIV-infected individuals to engage in care, or the success of ART once engaged(4). Findings from in-depth interviews with 35 women in Kisumu suggest that some HIV+ mobile women, e.g. market traders, take advantage of travel to obtain HIV care away from home communities in order to avoid stigma and disclosure; others organize travel around appointment schedules. But women miss appointments and interrupt treatment because of distance to clinics, travel schedules and costs. Mobility impinges on women’s ability to navigate the HIV care cascade in multiple, complex ways, with important implications for HIV care systems.