User and Provider Experiences with a Digital Health Family Planning Counseling Tool for Women Living with HIV in Kenya.

Abstract

Women living with HIV(WLHIV) have diverse and complex reproductive health needs that require patient-centered, informed decision-making. Digital tools to support reproductive life planning may improve reproductive health counseling and outcomes for these women. We evaluated user experiences with a self-administered, tablet-based family planning (FP) counseling tool as part of a digital health intervention implemented within a cluster randomized trial in Kenya. We conducted 10 focus group discussions with WLHIV (n = 95) who received the counseling tool and in-depth interviews (n = 10) with providers. Data were collected using semistructured guides, transcribed, translated, and thematically analyzed. Women's median age was 26 years, and 52 percent were married. Providers had a median of seven years' experience. WLHIV and providers found the counseling tool acceptable and felt it improved decision-making, FP knowledge, and patient-provider interactions. Women reported that the counseling tool supported informed FP decisions, improved awareness about less familiar options, and dispelled myths and misconceptions. Providers said the counseling tool helped tailor counseling, though it was challenging to use with women with more FP experience or with a selected method, but helpful among new FP users and adolescents. Participants also felt that the tool was lengthy. Tailoring the counseling tool and making it optional for specific groups of WLHIV may improve feasibility.