This study is a qualitative exploratory study assessing perceptions of barriers to retention of key populations living with HIV in HIV treatment among health care workers and program workers in key population-led organizations in Kenya. Structured interviews with the participants were conducted and analyzed thematically using themes derived from the Health Beliefs Model. Barriers that emerged from the interviews included individual barriers such as alcohol abuse, stigma, disclosure issues, faith-based healings, migration; and structural barriers such as the location of comprehensive care center in linking facilities, mishandling by health care workers after missed appointments, under staffing at health care facilities, and impersonalized care. Innovative means to improve retention included the use of peer navigators to follow up with HIV positive individuals that have defaulted from treatment, social support groups held by health facilities and key population organizations, storage of medication in key population organizations drop-in centers by HIV positive individuals because of non-disclosure issues, and having antiretroviral therapy dispensing sites within key population organizations. Additionally, it was suggested that peer evaluators currently working as volunteers should be made full time employees of key population led organizations and all key population led organizations should be made antiretroviral sites to improve retention rates of members of key population groups living with HIV.
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