Satisfaction With Use Of Public Health And Peer-Led Facilities For Hiv Prevention Services By Key Populations In Nigeria

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Abstract Objective: To identify the proportion of FSW, MSM and PWID who had accessed HIV prevention services at public health facilities and peer-led facilities, their level of satisfaction with these services and perceived barriers and challenges to accessing HIV services from public and peer-led HIV prevention service providers. Methods: A mixed method approach was used to collect data from key populations in four states in Nigeria. Data collected included level of satisfaction with and barriers to use of public and peer-led facilities. In-depth interviews and focus group discussions were conducted to explore reasons for satisfaction with and barriers to use of services. Descriptive and bivariate analysis was conducted for quantitative data. A ground theory approach was used to analyse the qualitative data. Results : There were 482 and 485 respondents to the questions on use of public health and peer-led facilities. Of these, 49.4% and 48.7% had received HIV and sexual and reproductive health services through the public health and peer-led facilities respectively. Significantly more respondents were satisfied with the quality of services provided by peer led organisations than public health facilities. Significantly more respondents using peer-led organisations than those using public health facilities identified no barriers to service access (p=0.003). More respondents using public health facilities than peer led facilities identified cost of services (p=0.01), confidentiality (p=0.002), waiting time (p<0.01) and staff attitude (p=0.001) as barriers to service access. There was no difference in the proportion of respondents willing to discontinue their use of either facilities (p=0.08). Qualitative data showed that concerns about access of services at the public health facility were related to healthcare worker discrimination and fear of being arrested due to the enacted same-sex prohibition law in Nigeria. Conclusion: Key populations had better satisfaction receiving HIV prevention services at peer led organisations than at public health facilities.

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