Providers' Perspectives on Provision of Family Planning to HIV-Positive Individuals in HIV Care in Nyanza Province, Kenya (original) (raw)
Related papers
2004
Thanks to Angeline Siparo, Country Director of the POLICY Project/Kenya, for her support, and Colette Aloo-Obunga for initial discussions around the discussion guides and review of the draft report. Special thanks are expressed to the research team which included Gerald Kimondo, Zablon Omungo, Caroline Wanjiru, and Mary Auma, for their invaluable contributions during data collection and transcription of field notes. We express our gratitude to Gerald Kimondo for his invaluable contribution during the data analysis stage using the Nu*DIST software program for qualitative data. Finally, to all we have not mentioned by name, we wish to express our sincere thanks for their contributions that warranted completion of this study. Contents Abbreviations .
International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Background: Women’s knowledge and access to reproductive health services improves their ability to safely achieve their required fertility and reduces maternal and infant morbidity and mortality. We aimed to determine the utilization of family planning (FP) among HIV Infected women visiting the HIV clinic.Methods: A cross-sectional mixed quantitative and qualitative study among HIV positive females in Nairobi, Kenya was conducted. Consenting women completed a questionnaire that assessed the utilization of FP services. Descriptive and inferential analysis was carried out on quantitative data to determine significant associations with FP utilization. Qualitative data were analyzed after coding for significant clauses and transcribing to determine themes arising.Results: We enrolled a total of 387 patients, mean age (IQ range) 40 years (36-44). The contraceptive prevalence was 53% with an unmet need of family planning of 38.5%. Patients were more likely to use family planning if they w...
International Journal of Gynecology & Obstetrics, 2013
Objective: To evaluate whether HIV-infected women and men in HIV care and not using highly effective methods of contraception thought they would be more likely to use contraception if it were available at the HIV clinic. Methods: A face-to-face survey assessing family-planning knowledge, attitudes, and practices was conducted among 976 HIV-infected women and men at 18 public-sector HIV clinics in Nyanza, Kenya. Data were analyzed using logistic regression and generalized estimating equations. Results: The majority of women (73%) and men (71%) thought that they or their partner would be more likely to use family planning if it were offered at the HIV clinic. In multivariable analysis, women who reported making family-planning decisions with their partner (adjusted odds ratio [aOR] 3.22; 95% confidence interval [CI], 1.53-6.80) and women aged 18-25 years who were not currently using family planning (aOR 4.76; 95% CI, 2.28-9.95) were more likely to think they would use contraception if integrated services were available. Women who perceived themselves to be infertile (aOR 0.07; 95% CI, 0.02-0.31) and had access to a cell phone (aOR 0.40; 95% CI, 0.25-0.63) were less likely to think that integrated services would change their contraceptive use. Men who were not taking antiretroviral medications (aOR 3.30; 95% CI, 1.49-7.29) were more likely, and men who were unsure of their partner's desired number of children (aOR 0.36; 95% CI, 0.17-0.76), were not currently using family planning (aOR 0.40; 95% CI, 0.22-0.73), and were living in a peri-urban setting (aOR 0.46; 95% CI, 0.21-0.99) were less likely to think their partner would use contraception if available at the HIV clinic. Conclusions: Integrating family planning into HIV care would probably have a broad impact on the majority of women and men accessing HIV care and treatment. Integrated services would offer the opportunity to involve men more actively in the contraceptive decision-making process, potentially addressing 2 barriers to family planning: access to contraception and partner uncertainty or opposition.
AIDS Care, 2015
Little information exists on the impact of integrating family planning (FP) services into HIV care and treatment on patients' familiarity with and attitudes toward FP. We conducted a clusterrandomized trial in 18 public HIV clinics with twelve randomized to integrated FP and HIV services and six to the standard referral-based system where patients are referred to an FP clinic. Serial cross-sectional surveys were done before (n=488 women, 486 men) and after (n=479 women, 481 men) the intervention to compare changes in familiarity with FP methods and attitudes toward FP between integrated and non-integrated sites. We created an FP familiarity score based on the number of more effective FP methods patients could identify (score range: 0-6). Generalized estimating equations were used to control for clustering within sites. An increase in mean familiarity score between baseline (mean=5.16) and post-intervention (mean=5.46) occurred with an overall mean change of 0.26 (95%CI= 0.09, 0.45; p=0.003) across all sites. At endline, there was no difference in increase of mean FP familiarity scores at intervention versus control sites (mean=5.41 vs. 5.49, p=0.94). We observed a relative decrease in the proportion of males agreeing that FP was "women's business" at integrated sites (baseline 42% to endline 30%; reduction of 12%) compared to males at non-integrated sites (baseline 35% to endline 42%; increase of 7%); aOR=0.43; 95%CI=0.22, 0.85). Following FP-HIV integration, familiarity with FP methods increased but did not differ by study arm. Integration was associated with a decrease in negative attitudes toward FP among men.
AIDS research and treatment, 2013
This study explored barriers to and facilitators of using family planning services among HIV-positive men in Nyanza Province, Kenya. From May to June 2010, in-depth interviews were conducted with 30 men receiving care at 15 HIV clinics. The key barriers to the use of family planning included concerns about side effects of contraceptives, lack of knowledge about contraceptive methods, myths and misconceptions including fear of infertility, structural barriers such as staffing shortages at HIV clinics, and a lack of male focus in family planning methods and service delivery. The integration of family planning into HIV clinics including family planning counseling and education was cited as an important strategy to improve family planning receptivity among men. Integrating family planning into HIV services is a promising strategy to facilitate male involvement in family planning. Integration needs to be rigorously evaluated in order to measure its impact on unmet need for contraception ...
Provision and Use of Family Planning in the Context of HIV/AIDS in Kenya
2004
Education programs targeting men, women, and youth should use BCC strategies to teach about VCT, HIV, and FP methods. Television, radio, and drama programs should be used. ix Health programs should include counseling to help men and women improve their communication skills and involve men in FP programs. HIV+ women (and men) should be trained as counsellors and FP providers to reach out to others in the community that are dealing with the same issues. Male involvement should be promoted through media, workplace initiatives, and clinic outreach. The aim of FP programs is to improve health status and help individuals and couples meet their reproductive intentions. The need for family planning still exists, especially in light of the growing HIV/AIDS epidemic. The government of Zambia and donors must recognize the continued need for expansion of FP programs that meet the needs of both HIV-positive and HIV-negative persons, and they need to commit the resources to make FP services available to all who need them.