title: Patient satisfaction with integrated HIV and antenatal care services in rural Kenya.
abstract: A cluster randomized controlled trial was initiated in Kenya to determine if full integration (FI) of HIV care, including HAART, into antenatal care (ANC) clinics improves health outcomes among HIV-infected women and exposed infants, compared to a non-integrated (NI) model. This article examines ANC clients' satisfaction with and preferences regarding HIV-integrated services. In this cross-sectional study, pregnant women attending five FI clinics (n=185) and four NI clinics (n=141) completed an interviewer-administered questionnaire following an ANC visit. By self-report, 55 women (17%) were HIV(+), 230 (71%) were HIV(-), and 40 (12%) did not know their HIV status. Among HIV-infected women, 79% attending FI clinics were very satisfied with their clinic visit compared to 54% of women attending NI clinics (P=0.044); no such difference was found among HIV-uninfected women. In multivariate analysis, overall satisfaction was also independently associated with satisfaction with administrative staff, satisfaction with health care providers, positive evaluation of wait time, and having encountered a receptionist. Full integration of HIV care into antenatal clinics can significantly increase overall satisfaction with care for HIV-infected women, with no significant decrease in satisfaction for HIV-uninfected women served in the same clinics.
authors.affiliation: Department of Family and Community Medicine, University of California, Davis, CA, USA. Baotran.Vo@ucdmc.ucdavis.edu
authors.forename: Baotran N
authors.initials: BN
authors.lastname: Vo
authors.forename: Craig R
authors.initials: CR
authors.lastname: Cohen
authors.forename: Rachel M
authors.initials: RM
authors.lastname: Smith
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Bukusi
authors.forename: Maricianah A
authors.initials: MA
authors.lastname: Onono
authors.forename: Katie
authors.initials: K
authors.lastname: Schwartz
authors.forename: Sierra
authors.initials: S
authors.lastname: Washington
authors.forename: Janet M
authors.initials: JM
authors.lastname: Turan
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration*; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000188:drug therapy / Q000517:prevention & control; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control; D007407:Interviews as Topic; D007630:Kenya; D016015:Logistic Models; D008427:Maternal Health Services / Q000458:organization & administration*; D015999:Multivariate Analysis; D017060:Patient Satisfaction; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis / Q000188:drug therapy / Q000517:prevention & control; D011295:Prenatal Care / Q000379:methods*; D015397:Program Evaluation; D019035:Rural Health Services / Q000458:organization & administration*; D012424:Rural Population; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents