Lois Hawkins1, Alida M Gertz1,2, Opelo Badubi2, Ontiretse Sickboy1, Aamirah Mussa2, Tshego Maotwe3, Paul G Whittaker4, Courtney A Schreiber4, Doreen Ramagola-Masire1,5, Chelsea Morroni1,2,6,7. 1. Botswana-UPenn Partnership, Gaborone, Botswana. 2. Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana. 3. Botswana Ministry of Health and Wellness, Gaborone, Botswana. 4. Department of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. 5. Department of Research and School of Medicine, University of Botswana, Gaborone, Botswana. 6. Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK. 7. Women's Health Research Unit, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
Abstract
OBJECTIVE: To create and assess a clinic model to address the unmet need for effective contraception among women living with HIV in Botswana, where half of all pregnancies are unintended and 30% of women of reproductive age are living with HIV. METHODS: We introduced family planning services into an HIV clinic in Gaborone, Botswana. Our intervention gave HIV providers brief training on contraceptive counseling plus the option of immediate referral of interested patients to an on-site contraception provider. We administered a survey to patients and providers before and after intervention. Patients were female, aged 18-45 years and using antiretrovirals. RESULTS: At baseline, 6% of 141 patients discussed contraception with their HIV-care provider, compared with 61% of 107 post intervention (P < 0.001). At baseline, 6% of patients reported wanting to use long-acting reversible contraception (LARC). Post intervention, 45% of patients chose to meet with the contraception provider, and 29% wanted to use LARC (P < 0.001 versus baseline). All providers strongly agreed that they were better informed about contraception post intervention and were satisfied with their ability to counsel and refer women for contraception. CONCLUSIONS: Provision of on-site contraceptive services in this HIV clinic encouraged family planning discussions and increased interest in LARC.
OBJECTIVE: To create and assess a clinic model to address the unmet need for effective contraception among women living with HIV in Botswana, where half of all pregnancies are unintended and 30% of women of reproductive age are living with HIV. METHODS: We introduced family planning services into an HIV clinic in Gaborone, Botswana. Our intervention gave HIV providers brief training on contraceptive counseling plus the option of immediate referral of interested patients to an on-site contraception provider. We administered a survey to patients and providers before and after intervention. Patients were female, aged 18-45 years and using antiretrovirals. RESULTS: At baseline, 6% of 141 patients discussed contraception with their HIV-care provider, compared with 61% of 107 post intervention (P < 0.001). At baseline, 6% of patients reported wanting to use long-acting reversible contraception (LARC). Post intervention, 45% of patients chose to meet with the contraception provider, and 29% wanted to use LARC (P < 0.001 versus baseline). All providers strongly agreed that they were better informed about contraception post intervention and were satisfied with their ability to counsel and refer women for contraception. CONCLUSIONS: Provision of on-site contraceptive services in this HIV clinic encouraged family planning discussions and increased interest in LARC.
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