MAMAS Study: Effects of HIV/AIDS Stigma on Use of Services by Pregnant Women in Kenya

The Maternity in Migori and AIDS Stigma Study (MAMAS Study) aims to understand the effects of HIV/AIDS stigma on service use by pregnant women in rural Kenya, and to use the knowledge gained to develop stigma reduction interventions for this vulnerable group. The research plan includes a prospective study of women who use antenatal care (ANC) services at clinics in Migori and Rongo Districts in Nyanza Province, Kenya, as well as qualitative research to elucidate the potential role of HIV/AIDS stigma as a barrier to health service use among women in the community who do not use ANC services. The MAMAS prospective study includes interviews with childbearing women at their first ANC visit, during late pregnancy, and after the birth. Around 1800 pregnant women who come to ten clinics for their first ANC visit and do not yet know their HIV status are being interviewed before their first visit to assess their perceptions of HIV/AIDS stigma, uptake of HIV testing, and other variables. A subsample of these women (n=900) are re-interviewed during their last month of pregnancy and then again at six weeks postpartum to assess changes in perceptions and experiences of stigma, number of ANC visits completed, place of delivery, postpartum checkups, and enrollment in HIV care and treatment. The qualitative research component will consist of in-depth interviews with:

• Women who did not use maternity services for a recent pregnancy
• Traditional birth attendants
• Community health workers
• Male partners of women who did not use maternity services

The final step will be to integrate the findings from the quantitative and qualitative data and use them to guide the development of an intervention to reduce HIV/AIDS stigma that adversely affects pregnant women in Kenya.