Factors and Priorities Influencing Satisfaction with Care among Women Living with HIV in Canada: A Fuzzy Cognitive Mapping Study

Abstract

Engagement along the HIV care cascade in Canada is lower among women compared to men. We used Fuzzy Cognitive Mapping (FCM), a participatory research method, to identify factors influencing satisfaction with HIV care, their causal pathways, and relative importance from the perspective of women living with HIV. Building from a map of factors derived from a mixed-studies review of the literature, 23 women living with HIV in Canada elaborated ten categories influencing their satisfaction with HIV care. The most central and influential category was “feeling safe and supported by clinics and healthcare providers”, followed by “accessible and coordinated services” and “healthcare provider expertise”. Participants identified factors that captured gendered social and health considerations not previously specified in the literature. These categories included “healthcare that considers women’s unique care needs and social contexts”, “gynecologic and pregnancy care”, and “family and partners included in care.” The findings contribute to our understanding of how gender shapes care needs and priorities among women living with HIV.

Experiences and resultant care gaps among women with HIV in Canada: concept mapping the Canadian HIV Women’s Sexual and Reproductive Health Cohort Study (CHIWOS) findings

“…The Summary Fuzzy Cognitive Map they produced shows the weightings of categories influencing satisfaction of care, with the most significant being feeling safe and supported by healthcare providers, accessible services, and healthcare provider expertise. 24 These mirror some of our findings in our composite concept maps 2 and 6 which show the relationships among access to care, comprehensive care, and feelings of stigma. Both studies offer valuable visual insights into women’s experiences, complementing each other and contributing to a comprehensive understanding when interpreted together.…”

“…Recently, fellow CHIWOS investigators also employed mapping techniques to examine the experiences of women with HIV in accessing care. Skerritt et al 24 used Fuzzy Cognitive Mapping, a participatory research method, to identify factors influencing satisfaction with HIV care and to understand engagement in the HIV care cascade. The Summary Fuzzy Cognitive Map they produced shows the weightings of categories influencing satisfaction of care, with the most significant being feeling safe and supported by healthcare providers, accessible services, and healthcare provider expertise 24.…”

“…Skerritt et al 24 used Fuzzy Cognitive Mapping, a participatory research method, to identify factors influencing satisfaction with HIV care and to understand engagement in the HIV care cascade. The Summary Fuzzy Cognitive Map they produced shows the weightings of categories influencing satisfaction of care, with the most significant being feeling safe and supported by healthcare providers, accessible services, and healthcare provider expertise 24. These mirror some of our findings in our composite concept maps 2 and 6 which show the relationships among access to care, comprehensive care, and feelings of stigma.…”

Navigating antiretroviral adherence in boarding secondary schools in Nairobi, Kenya: A qualitative study of adolescents living with HIV, their caregivers and school nurses

“…These included opting for HIV non-disclosure, lying about their medication and health condition, changing medication storage containers, moderating their participation in peer discussions on HIV issues, and negotiating for priority services in their school PLOS GLOBAL PUBLIC HEALTH clinics. These finding are similar to those of Skemitt et al, which explored how factors and priorities influenced satisfaction with care [35].…”

Fuzzy cognitive mapping in participatory research and decision making: a practice review

“…Balanced diet and iron-rich for adolescent girls in rural Ghana [ 42 ] In the context of a randomised trial, mapping sessions helped adolescent girls to identify and reflect on pressing issues that they would address in a co-designed video intervention Ghana, 2020 20 stakeholder maps, 181 participants 20. Satisfaction with HIV care [ 81 ] Women living with HIV shared their experiential expertise to adjust literature maps on factors contributing to satisfaction with HIV care Canada, 2021 24 stakeholder maps, 23 participants and one literature map 21. Sexual & reproductive health of adolescents [ 82 ] Communities in Northern Nigeria share their views on factors influencing adolescent sexual & reproductive health Nigeria, 2022 77 stakeholder maps, 312 participants 22.…”