Table 5 Themes on provider responsiveness
Themes | Sub-themes | Exemplar quotes |
|---|---|---|
Knowledge of aPS | Knowledgeable | " Sometimes you call and the client tells you I am busy, that one you still document. But it should be at least three or four times before you make a physical attempt." KII 017 |
Individual provider response to aPS | Positive: Building rapport | " At the start of counseling, testing and linkage to care, you have created good rapport with this client, (and) you will be a king or a queen to (them) concerning their health especially on HIV care because she or he will say that the first person who contacted him inside the health facility for her treatment was you." KII 019 |
Positive: High sex partner elicitation | " I like aPS because it gives us so many SPs (sexual partners).… You know after index gives you like 4, 5 sex partners, it will help you get more. So, you know if you go and test like all those 5, about 3 or 2 must be HIV positive and that helps us make them know their status so that you can make them start taking medicine." KII 020 | |
Positive: Improved awareness of HIV status | "Another thing is that you are going to help this client because if the clients know their HIV status early enough. Sometimes, the client had not planned to go to the facility for testing but now you have gone to them and they are tested early enough, you see they will start treatment early enough in case they are positive and in case they are negative then we shall teach them how they can take care of themselves." KII 027 | |
Positive: Improved linkage to care | "So, the moment you identify somebody is positive, putting this person on care early you prevent a lot of issues like opportunistic infections or other complications that might come as a result of not seeking treatment in time.” KII 016 | |
Positive: Improved provider skills | "Interviewer: What do you like about doing provider referral in particular? Provider: (light laugh) It is good because it makes you gain some knowledge and tricks of getting to the person, you must use your tricks on how to meet the person. (You ask yourself) “How will I meet this person? What will I do? In such and such a situation, what do I do exactly so that I may reach this person?” KII 028 | |
Negative: Challenges with provider safety | "Another bad experience, I was chased by a machete. If it was not for my motorbike, I don’t know how that could have gone. I had my motorbike with me. That has always been my rule. I leave my motorbike on at the front of the house with a very low sound. I finish with you and take off immediately. It is always left on when I go for tracing and don’t turn off the key." KII 022 "I am saying that the client can tell you to go to his/her place to do the test and maybe when you get there the client has a different agenda towards you. Maybe he wanted to seduce you or maybe he wants to touch you suggestively or maybe he wants to rape you. Things like that, those are some of the challenges that are there" KII 030 | |
Negative: Tracing challenges | "You find that it is also hard in that during the physical tracing, you need to go out and the sun is so scorching and you have to walk very far where the motorbikes cannot reach" KII 021 | |
Interpersonal (client – provider) response to aPS | Positive: Client’s positive reactions | "Last month I got a female positive enrolled for the first time. She had issues with the drugs she was given. Instead of talking to the clinician who served her she came to consult with me…On her next appointment when she came back to the clinic, she came straight to me without going to the CCC where she had the appointment….She said she was scared to talk to the clinician who gave her the drugs. What I discovered with that story is that the first encounter with a client is the one that will decide whether they will open up and trust you or not." KII 019 |
Negative: Client’s negative responses | "The experience has been good but sometimes you find some clients who are harsh. They will start asking you, where did you find my number, who are you and you know some are harsh. But for you, just relax and talk slowly and maybe…. you don’t lose hope. You keep calling and maybe after two three days the client will agree." KII 020 |