184760 Knowledge, Attitudes, and Practices related to Family Planning among HIV Care Providers in Nyanza Province, Kenya

Monday, October 27, 2008: 12:30 PM

Sara J. Newmann, MD MPH , Obstetrics, Gynecology, and Reproductive Sciences, San Francisco General Hospital, University of California, San Francisco, San Francisco, CA
Craig Cohen, MD, MPH , OB/GYN and Reproductive Sciences, University of California, San Francisco, San Francisco, CA
Daniel Kwaro, MD , KEMRI, Nairobi, Kenya
Olivia Gage, BA , School of Medicine, University of North Carolina, Carrboro, NC
Elizabeth Bukusi, MD, MPH, PhD , Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
Daniel Grossman, MD , Ibis Reproductive Health, San Francisco, CA
Background:

Among HIV-infected women in sub-saharan Africa, between 50-90% of all pregnancies are unintended. In much of Africa, family planning (FP) has not been integrated into HIV care. This mixed-methods study is conducted to inform a planned intervention to integrate FP into HIV care in Nyanza Province, Kenya. The study aims to assess FP knowledge, attitudes, and practices (KAP) among HIV care providers.

Methods:

Thirty structured interviews will be conducted among a convenience sample of healthcare workers from twelve public HIV clinics in Nyanza Province, Kenya. Structured questions and case scenarios assess contraceptive knowledge, training, and provision experience. Open-ended questions collect providers' opinions about integration. Quantitative data will be analyzed in frequencies and appropriate comparisons. Grounded theory will guide content analysis of the qualitative data.

Results:

Of the 18 healthcare workers already interviewed, eleven (61%) reported previous FP training. Most regarded implants 14 (78%), injectables 13 (72%), and OCP's 13 (72%) as safe for HIV-infected women. Only eight (44%) thought the IUC was safe. Although all reported counseling clients on FP, only six (33%) had worked at a clinic where contraception, other than condoms, was available. Themes expressed as potential barriers to integration were myths about contraceptive side effects, shortage of staff, lack of training, and availability of commodities.

Conclusions:

Misconceptions exist about the safety of contraception, especially the IUC, for HIV-infected women. To increase access to FP, providers suggested additional FP training, improving the availability of FP commodities in HIV care settings, and increasing the number of staff.

Learning Objectives:
1. To describe current knowledge, attitudes, and practices regarding family planning among a sample of Kenyan HIV care providers. 2. To identify and discuss Kenyan healthcare providersí perceptions of cultural, logistical, structural, and educational barriers to contraception among HIV-infected women.

Keywords: HIV/AIDS, Family Planning

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am currently conducting research in the area of integrating family planning into HIV care in Kenya, Africa.
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.