User experiences with a digital health family planning counseling tool for women living with HIV in Kenya

Women with HIV(WLHIV) have diverse and complex reproductive health needs that require patient-centered, informed decision making. Digital tools to support reproductive life planning may improve reproductive health counseling and outcomes for these women. We evaluated user-experiences with a self-administered, tablet-based family planning(FP) counseling tool as part of a packaged digital health intervention evaluated in a cluster randomized trial in Kenya. We conducted focus group discussions with WLWH who received the counseling tool(n=10) and in-depth interviews with providers(n=10). Data were collected using semi-structured guides, transcribed, translated, and thematically analyzed. Among 95 women, median age was 26 years and 52% were married. Providers had median 7 years experience. WLWH and providers found the counseling tool acceptable, and felt it improved decision-making, FP knowledge, and patient-provider interactions. Women reported the counseling tool supported informed FP decisions, educated on less familiar options, and dispelled myths and misconceptions. Providers said the counseling tool helped tailor counseling though it was challenging to use with women with more FP experience or with a selected method, but helpful among FP-initiators and adolescents. The counseling tool was useful and acceptable, but too lengthy. Tailoring the counseling tool and making it optional for specific groups of WLWH may improve feasibility.