Childbirth experiences for women living with HIV in Kilimanjaro, Tanzania: a mixed method study on respectful maternity care.

Respectful maternity care (RMC) is important for women living with human immunodeficiency virus (WLHIV) to promote their well-being and long-term healthcare engagement. This descriptive mixed-methods study explored the experiences of RMC during childbirth among WLHIV in Tanzania.We conducted a mixed-methods study and recruited 103 WLHIV from six healthcare facilities within 48 h of giving birth. Participants completed a survey using audio computer-assisted self-interview survey technology. In-depth interviews were conducted with 12 pregnant WLHIV and 12 postpartum WLHIV.In the survey, self-reported RMC was overall high. The median score on the full RMC scale (possible range 0-100) was 74.4, with the highest scores in the subscale of dignity and respect (83.3), followed by supportive care (77.8) and communication and autonomy (62.9). Qualitative data suggested a general appreciation of the care received, but some participants reported that providers neglected them, avoided physical contact or did not seek their consent for procedures.These data suggest an opportunity for additional provider training in clinical empathy and patient-centred practices to address the unique needs of WLHIV and enhance their overall maternity care satisfaction and health outcomes. There is also a need for investments in clinical infrastructure to support the delivery of RMC.