The Influence of Gender Related Factors on Access to Art in Selected Treatment Sites in Nairobi, Kenya
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Date
2008
Authors
Kamau, Richard Thuo
Journal Title
Journal ISSN
Volume Title
Publisher
Kenyatta University
Abstract
Globally, it is estimated that there are 33.2 million people living with HIV/AIDS, of which
22.8 million are in Africa. In Africa 13.7 (61%) of the people living with HIV/AIDS are
women. Kenya's HIV/AIDS prevalence stands at 6.1%, with 6.7% prevalence amongst
women and 3.5% amongst the men. In Nairobi, the gender based prevalence is 12.3% for
women and 8.0% for men. The indications are that there are more HIV -positive women than
men globally and nationally. The objectives of the study were to establish the influence of
socio-demographic, socio-economic and socio-cultural GRFs on access to ART in Nairobi,
through a survey study. Two hundred and fifty five patients derived from 8 ART sites took
part in the study. A multistage sampling technique was used to select the elements of the
sample population. The first stage involved stratifying the hospitals on the basis of whether
the hospital was public, non-governmental organisation (NGO) or private for profit. From
each stratum, the study treatment centres were selected using a systematic sampling
technique and proportionate to size sampling. From the selected treatment centres, patients
were further stratified into male and female, and from each stratum, they were recruited for
inclusion in the sample by simple random proportionate to size sampling. Permission to
undertake the research was secured to conform to ethical protocol. An investigatoradministered
questionnaire was used for data collection. Data was analysed by use of SPSS
version-IO software, and presented using descriptive statistics. The Chi-square was used to
test significance. The results showed that the number of females visiting ART clinics is twice
that of males. Moreover, in the 18-26 years age bracket, females were 3 times more affected
than males, an indication that sex of the patient has an influence on access to ART. The
marital status carried a 5-fold risk of carrying the virus while women were twice as likely to
be infected by their husbands as compared to men getting the virus from their wives. The
lower the formal education, the higher the chances of carrying the virus, and this affected
women more than men. This would be expected to force a positive influence on access to
ART in favour of women. However, the findings suggest men have a slight advantage over
women on access to ARVs. The number of men with income was double that of women,
suggesting that if services were to be paid for, men would have an advantage for ART access
over women. Access to ART services was negatively affected by the distance from residence
to the clinic, and about 50% of all patients had problems getting time-off from workplace to
visit clinics. Patient perception of the attitude of health staff, and the quality of ART services
was up to 90% good, but the clinic schedules preclude about 10% of the patients from access.
Social stigma was low (about 10%) within spouses, and very high (about 90%) outside the
institution of marriage, and women bore the larger burden of the stigma. The results also
suggest that gender segregated clinics would have no influence on the number of patients
attending the clinics. The overall conclusion is that gender related factors have an influence
on access to ART. The potential usefulness of these findings lies in their use as an advocacy
tool for gender equity in provision of ART services.
Description
A Thesis Submitted in Partial Fulfilment of the requirements for the Degree of Master of Public Health in the School of Health Sciences of Kenyatta University, October 2008