Identifying religion's impact on HIV service provision with stigmatized groups and developing models that draw on religion's positive contributions

The U.S. President’s Emergency Plan for AIDS Research (PEPFAR) named four key populations – men who have sex with men, sex workers, people who inject drugs, and young women – as the focus of continued global response to HIV/AIDS. In Kenya, key populations face a high burden of HIV, but encounter barriers to HIV prevention and treatment due to social, religious, legal and political forces. In this context, PEPFAR relies upon faith-based organizations (FBOs) as the largest non-governmental providers of HIV services as central to effective and sustained HIV prevention, treatment and support services. However, little is known about the role of religion in addressing the stigma and discrimination faced by key populations. We employed qualitative methods informed by the principles of Grounded Theory to understand the role of religion on stigma and access to HIV services for key populations in Kenya. Kenyan researchers conducted key informant interviews (KII) and focus group discussions (FGD) with FBO staff and members of key populations across six counties (Eldoret, Kiambu, Kilifi, Kisumu, Mombasa and Nairobi). There were 190 participants across all interviews and focus group discussions. Interviews were conducted in English and Swahili and all data was transcribed in English for analysis. Data were coded with a combination of inductive and deductive codes. Coded data was analyzed to compare the experiences of key populations, religious groups, and to explore regional differences. Codes were grouped into categories and mapped into a conceptual model to explain the role religion has on stigma, discrimination, and access to HIV prevention and treatment services among key population