Integration of HIV Care with Primary Health Care Services: Effect on Patient Satisfaction and Stigma in Rural Kenya

Table 1

Comparison of features of health facilities in an evaluation of HIV service integration in Suba District, Kenya.

	Patient support center (HIV clinic) before integration	Out-patient department (OPD) before integration	Integrated facility
Clinic space	Separate room for HIV clinical care	Separate room for primary care services other than HIV	All clinical rooms used for both HIV and other primary care services
Clinical staff	One clinician (clinical officer or nurse) dedicated to providing HIV care	Other clinicians attending to patients seeking primary care exclusive of HIV	All clinicians attend to all patients regardless of HIV status
Health education at waiting bay	General health education with emphasis on HIV care, treatment, and nutrition	General health education with equal emphasis on all topics. Messages about HIV mostly relate to prevention	General health education on all health topics including HIV prevention, care, and treatment
Pharmacy/Supplies	Staff extensively trained and mentored on commodity management and supply chain logistics especially relating to ART	Little or no training on commodity management. No mentorship.; Poor supply chain hence frequent drug stock-outs	Intensive on-job training and mentorship on commodity management.; Streamlined supply chain; less frequent drug stock-outs
Laboratory	Lab samples sent to well-stocked central lab at district hospital. Tests available for HIV-positive patients include CD4, CBC, hematology, microscopy, biochemistry, and immunology. More reliable supply of reagents; specimen transport network for remote sites	Labs poorly equipped. Tests available: Hb, pregnancy, and simple microscopy. Frequent stock out of reagents	Samples that cannot be processed locally sent to central lab at district hospital. Specimen transport network used for all specimens. Training and mentorship offered to all staff.
Focused HIV training and mentorship	Clinician well trained in HIV care (adult and pediatric ART, PMTCT); weekly mentorship by more experienced clinicians	Some staff trained but not actively practicing; no clinical mentorship	All staff trained in at least one HIV care course. Weekly mentorship and on-job training for all staff