Higher contraceptive uptake in HIV treatment centers offering integrated family planning services: A national survey in Kenya.
Contraception
Family planning
HIV
Integration
Kenya
Journal
Contraception
ISSN: 1879-0518
Titre abrégé: Contraception
Pays: United States
ID NLM: 0234361
Informations de publication
Date de publication:
07 2020
07 2020
Historique:
received:
18
11
2019
revised:
01
04
2020
accepted:
06
04
2020
pubmed:
17
4
2020
medline:
16
10
2021
entrez:
17
4
2020
Statut:
ppublish
Résumé
Integrating family planning (FP) into routine HIV care and treatment are recommended by WHO guidelines to improve FP access among HIV-infected individuals in sub-Saharan Africa. This study sought to assess factors that influence the delivery of integrated FP services and the impact of facility-level integration of FP on contraceptive uptake among women living with HIV (WLWH). A national cross-sectional study was conducted among WLWH at HIV Care and Treatment centers with >1000 antiretroviral treatment (ART) clients per year. A mobile team visited 108 HIV Care and Treatment centers and administered surveys to key informants regarding facility attributes and WLWH regarding FP at these centers between June and September 2016. We classified facilities offering FP services within the same facility as 'integrated' facilities. 4805 WLWH were enrolled at 108 facilities throughout Kenya. The majority (73%) of facilities offered integrated FP services. They were more likely to be offered in public than private facilities (Prevalence Ratio [PR]: 1.86, 95% Confidence Interval [CI]: 1.11-3.11; p = 0.02] and were more common in the Nyanza region than the Nairobi region (77% vs 35% respectively, p = 0.06). Any contraceptive use (89% vs 80%), use of modern contraception (88% vs 80%), dual method use (40% vs 30%), long-acting reversible contraception (LARC) (28% vs 20%), and non-barrier short-term methods (34% vs 27%) were all significantly higher in facilities with integrated FP services (p < 0.001). The majority of high volume facilities integrated FP services into HIV care. Integrating FP services may increase modern contraceptive use among WLWH. Integration of FP services was associated with higher modern contraceptive use, lower unmet need for modern methods and higher use of long-acting, reversible contraception (LARC), and non-barrier short-term methods among women living with HIV. Despite high prevalence of integration of FP services, organizational challenges remain at integrated clinics.
Identifiants
pubmed: 32298715
pii: S0010-7824(20)30106-2
doi: 10.1016/j.contraception.2020.04.003
pmc: PMC7405607
mid: NIHMS1593470
pii:
doi:
Substances chimiques
Contraceptive Agents
0
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Pagination
39-45Subventions
Organisme : NIAID NIH HHS
ID : K01 AI116298
Pays : United States
Organisme : NIAID NIH HHS
ID : P30 AI027757
Pays : United States
Organisme : NCHHSTP CDC HHS
ID : U2G PS002047
Pays : United States
Organisme : PEPFAR
Pays : United States
Informations de copyright
Copyright © 2020 Elsevier Inc. All rights reserved.
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