175254 Fertility Desires and Contraceptive Demand of HIV Positive Women Attending Care and Treatment Services in Nakuru, Rift Valley, Kenya

Monday, October 27, 2008: 4:30 PM

Sharon Tsui, MPH , Behavioural and Biomedical Research Department, Family Health International, Research Triangle Park, NC
Jane Alaii, PhD , C-Change, Academy for Educational Development, Kenya, Nairobi, Kenya
Jennifer Liku, MSW , Family Health International - Kenya, Nairobi, Kenya
Heidi Reynolds, PhD, MPH , Health Services Research, Family Health International, Research Triangle Park, NC
Greg Guest, PhD , Behavioural and Biomedical Research Department, Family Health International, Research Triangle Park, NC
Background: HIV+ women are at risk of unintended pregnancy and lack access to family planning (FP) services. FP, however, is not typically offered at HIV care and treatment (CT) centres. This study examined fertility desires and contraceptive needs of HIV+ female CT clients; and assessed clients' and providers' attitudes toward FP/ CT integration.

Methods: A cross-sectional study was conducted at a provincial CT centre from June-December 2007. 479 HIV+ women aged 18-45 completed a survey and 16 completed in-depth interviews (IDI). 6 CT providers participated in IDIs and 1 focus group discussion.

Results: 50% of women surveyed said their last birth was unintended. Current unmet FP need was 30%. Although male condoms were the most commonly used FP method (74%), many women discussed difficulty in negotiating consistent condom use with their sexual partners, indicating unmet need may be higher.

75% women surveyed desired FP at CT. Participants said integration would reduce the time and cost of accessing both services, and believed their rapport with CT providers would allow providers to tailor FP counselling to their HIV disease progression. Providers recognized clients' contraceptive needs, and identified specific challenges to FP integration (i.e. space, staff time, client flow, provider training, etc).

Conclusion: Many HIV+ female clients support integration because CT is a trusted environment and would become a convenient ‘one-stop shop'. Provider training, structural and organizational service delivery elements must be addressed for effective integration. Any integration efforts should be evaluated for their effect on contraceptive use and CT service quality.

Learning Objectives:
1. Highlight relevance of integrating family planning into an HIV/AIDS care and treatment services to prevention of HIV+ births and unintended pregnancy. 2. Characterize fertility desire and contraceptive demands of HIV+ female clients attending care and treatment services in Nakuru, Kenya. 3. Discuss clients' and providers' attitudes toward integrating family planning into HIV/AIDS care and treatment (CT) services. 4. Identify necessary training and service delivery steps for effective FP-CT integration in Kenya.

Keywords: HIV/AIDS, Family Planning

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I developed, implemented, and managed the study, and analyzed the data findings.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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