Preferences for accessing sexual and reproductive health services among adolescents and young adults living with HIV/AIDs in Western Kenya: A qualitative study

PLoS One. 2022 Nov 16;17(11):e0277467. doi: 10.1371/journal.pone.0277467. eCollection 2022.


Despite the need, adolescents and young adults (AYAs) in resource-limited settings have limited access to sexual and reproductive health (SRH) care services for improved health outcomes. This is worse for AYAs living with HIV in resource-limited settings where much is unknown about contexts and issues inhibiting access to SRHs. We explored adolescents', healthcare workers, and caregivers' preferences for access to sexual and reproductive health services for adolescents and young adults living with HIV. We conducted 30 in-depth interviews and 8 focus group discussions among a subset of AYA aged 14-24 living with HIV, healthcare workers, and caregivers/parents. We recruited participants from Lumumba Sub-County Hospital (KLM) and Kisumu County Referral Hospitals in Kisumu County (KCH). Trained and experienced qualitative research assistants 5-10 years older than the adolescents conducted interviews and facilitated discussions using guides designed to elicit detailed views and perspectives on sex and sexuality, access to SRH services, challenges of AYA living with HIV, and potential interventions to improve access to SRH services. Audio files were transcribed verbatim and translated to English where necessary before coding and analysis. We applied constant comparative analysis for theme and content to arrive at our conclusions. Our analysis yielded two main themes: preferences for a venue for SRH services and choices for qualities of an SRH counsellor. We found that AYAs generally preferred receiving SRH services to be co-situated within clinical facilities. We also observed gender differences in the qualities of SRH providers, with male AYAs preferring older male service providers compared to females who preferred younger female providers close to their age. The study highlighted the preferences of AYAs for accessing SRH, which need to be considered when designing their health programs. Further, AYAs seem to endite health systems to individualize access to SRH for AYAs living with HIV by providing a combination of attributes that meet individual preferences.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Female
  • HIV Infections* / therapy
  • Humans
  • Kenya
  • Male
  • Qualitative Research
  • Reproductive Health
  • Reproductive Health Services*
  • Sexual Behavior
  • Young Adult

Grants and funding

This study was an internally funded at Kenya Medical Research Institute. MON is the author who received the award. Sponsors and funders did not play a role in the study design, data collection and analysis, decision to publish, or preparation for the manuscript. 1. HAF was a Research Assistant in the project. Her roles included conducting participant interviews, transcription, coding and analysis. 2. ZK and MON-Principal Investigators ZK and MON provided oversight of research development and implementation. ZK was directly involved in leading and supervising the qualitative activities including focus group and individual interview guide development, conducting interviews, coding/analysis and results dissemination. MON was involved in the management of local regulatory supervision and administration of the study. All authors reviewed and approved the manuscript.