Integrating family planning and HIV services in western Kenya

The impact on HIV-infected patients’ knowledge of family planning and male attitudes toward family planning

Bibliographic Data

ID19439465
AuthorsMaricianah Onono (0000-0001-6847-8762, Kenya Medical Research Institute, corresponding author), Mary A Guzé (University of California, San Francisco), Daniel Grossman (0000-0002-6878-6201, Ibis Reproductive Health), Rachel Steinfeld, Rachel L Steinfeld (University of California, San Francisco), Elizabeth A Bukusi (0000-0002-2031-2808, Kenya Medical Research Institute), Starley B Shade (0000-0001-8172-4649, University of California, San Francisco), Starley Shade, Craig R Cohen (0000-0001-8654-6634, University of California, San Francisco), Sara J Newmann (0000-0002-2672-0191, University of California, San Francisco)
Year2015
Volume27
Issue6
Pages743-752
Publication date2015-06-03
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueAIDS Care (JOURNAL)
Journal identifiersISSN: 0954-0121 • E-ISSN: 1360-0451
PublisherInforma UK Limited (PUBLISHER • GB)
DOI10.1080/09540121.2014.999744
PMID25634244
PMCIDPMC4366270
OpenAlexW1983435181
LanguageEN
Citations received6
References cited22

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 cluster-randomized trial in 18 public HIV clinics with 12 randomized to integrated FP and HIV services and 6 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 nonintegrated (NI) 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% confidence intervals [CI] = 0.09, 0.45; p = 0.003) across all sites. At end line, 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 end line 30%; reduction of 12%) compared to males at NI sites (baseline 35% to end line 42%; increase of 7%; adjusted odds ration [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

Biology · Cluster randomised controlled trial · Confidence interval · Environmental health · Family medicine · Family planning · Generalized estimating equation · Logistic regression · Odds · Odds ratio · Population · Randomized controlled trial · Referral · Sociology · Statistics · Adolescent Sexual and Reproductive Health · Demography · Global Maternal and Child Health · HIV/AIDS Research and Interventions · Medicine · Nursing · Internal Medicine