Integrating family planning and HIV services increases contraceptive knowledge and use

Countries in Sub-Saharan Africa have some of the lowest family planning use rates in the developing world. Approximately 30% of women in the region have an unmet need for family planning services and methods, which is even higher among women living with HIV. A large cluster randomized trial conducted by the UCSF Bixby Center examined if integrating family planning with HIV/AIDS services can help bridge this gap and increase the use of contraception among HIV-positive women and men. The study was a collaboration with the Kenya Medical Research Institute, and took place in Kenya's Nyanza Province.

The main study found that women who visited health sited that integrated HIV and family planning services were significantly more likely to use more effective contraceptive methods at the end of the study, compared with women who visited clinics where clients desiring contraception were referred to family planning clinics at the same facility.

In a second, study, researchers surveyed HIV-positive men and women currently in HIV care but not using highly effective methods of contraception. Over 70% thought that they or their partner would be more likely to use family planning if it were offered at the HIV clinic. The authors stress that integrating family planning into HIV care would likely have a large impact on the majority of women and men accessing HIV care and treatment. Integrating these services also would present the opportunity to involve men more actively in the contraceptive decision-making process, potentially addressing two major barriers to family planning: access to contraception and partner uncertainty or opposition.

In a third study, researchers aimed to determine if community clinic health workers in rural Kenya talking with HIV-positive patients about family planning would improve contraceptive knowledge and attitudes. Following 15-minute health talks with almost 50 HIV-positive men and women, there was a significant increase in knowledge about contraceptives. Additionally, 45% of women and 33% of men intended to try a new contraceptive, suggesting that providing family planning education to patients as they wait for HIV services can increase both knowledge and intention to use contraception.

These collaborative studies reveal that integrating family planning into HIV care result in increased use of effective contraceptive methods among HIV-infected women and men. Researchers also stressed that integrating family planning and HIV services will require leadership at the community, regional, national and international levels.