Rubee Dev1, Pamela Kohler2, Emily Begnel2, Dunstan Achwoka3, Christine J McGrath3, Jillian Pintye3, Wangui Muthigani4, Benson Singa5, Joel Gondi4, Lucy Ng'ang'a3, Agnes Langat3, Grace John-Stewart6, John Kinuthia7, Alison L Drake8. 1. Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada; Department of Child, Family, and Population Health Nursing and Department of Global Health, University of Washington, Seattle, WA, United States. 2. Department of Child, Family, and Population Health Nursing and Department of Global Health, University of Washington, Seattle, WA, United States. 3. US Centers for Disease Control and Prevention (CDC), Division of Global HIV & TB (DGHT), Nairobi, Kenya. 4. Reproductive and Maternal Health Service Unit, Ministry of Health, Nairobi, Kenya. 5. Kenya Medical Research Institute, Nairobi, Kenya. 6. Department of Child, Family, and Population Health Nursing and Department of Global Health, University of Washington, Seattle, WA, United States; Department of Epidemiology, University of Washington, Seattle, WA, United States; Department of Pediatrics, University of Washington, Seattle, WA, United States; Department of Medicine, University of Washington, Seattle, WA, United States. 7. Department of Research and Programs, Kenyatta Hospital, Nairobi, Kenya. 8. Department of Child, Family, and Population Health Nursing and Department of Global Health, University of Washington, Seattle, WA, United States. Electronic address: adrake2@uw.edu.
Abstract
OBJECTIVES: To characterize contraceptive counseling experiences among women living with HIV (WLWH) receiving HIV care in Kenya. STUDY DESIGN: Sexually active, WLWH aged 15 to 49 years were purposively sampled from 109 high-volume HIV Care and Treatment Centers in Kenya between June and September 2016. Cross-sectional surveys were administered to enroll women on a tablet using Open Data Kit. Poisson generalized linear regression models adjusted for facility-level clustering were used to examine cofactors for receiving family planning (FP) counseling with a provider. RESULTS: Overall, 4805 WLWH were enrolled, 60% reported they received FP counseling during the last year, 72% of whom reported they were counseled about benefits of birth spacing and limiting. Most women who received FP counseling were married (64%) and discussed FP with their partner (78%). Use of FP in the last month (adjusted Prevalence Ratio [aPR] = 1.74, 95% confidence interval [CI]: 1.41-2.15, p < 0.001), desire for children in >2 years (aPR = 1.18, 95% CI: 1.09-1.28, p < 0.001), and concern about contraceptive side-effects (aPR = 1.13, 95% CI 1.02-1.25, p < 0.05) were significantly higher among WLWH who received FP counseling compared to those that did not. CONCLUSIONS: Over one-third of WLWH did not receiving FP counseling with an HIV care provider during the last year, and counseling was more commonly reported among women who were using FP or desired children in >2 years. IMPLICATIONS: There are missed opportunities for FP counseling in HIV care. FP integration in HIV care could improve FP access and birth spacing or limiting among WLWH.
OBJECTIVES: To characterize contraceptive counseling experiences among women living with HIV (WLWH) receiving HIV care in Kenya. STUDY DESIGN: Sexually active, WLWH aged 15 to 49 years were purposively sampled from 109 high-volume HIV Care and Treatment Centers in Kenya between June and September 2016. Cross-sectional surveys were administered to enroll women on a tablet using Open Data Kit. Poisson generalized linear regression models adjusted for facility-level clustering were used to examine cofactors for receiving family planning (FP) counseling with a provider. RESULTS: Overall, 4805 WLWH were enrolled, 60% reported they received FP counseling during the last year, 72% of whom reported they were counseled about benefits of birth spacing and limiting. Most women who received FP counseling were married (64%) and discussed FP with their partner (78%). Use of FP in the last month (adjusted Prevalence Ratio [aPR] = 1.74, 95% confidence interval [CI]: 1.41-2.15, p < 0.001), desire for children in >2 years (aPR = 1.18, 95% CI: 1.09-1.28, p < 0.001), and concern about contraceptive side-effects (aPR = 1.13, 95% CI 1.02-1.25, p < 0.05) were significantly higher among WLWH who received FP counseling compared to those that did not. CONCLUSIONS: Over one-third of WLWH did not receiving FP counseling with an HIV care provider during the last year, and counseling was more commonly reported among women who were using FP or desired children in >2 years. IMPLICATIONS: There are missed opportunities for FP counseling in HIV care. FP integration in HIV care could improve FP access and birth spacing or limiting among WLWH.
Authors: Margaret R Caplan; Khumbo Phiri; Julie Parent; Ann Phoya; Alan Schooley; Risa M Hoffman Journal: Clin Obstet Gynecol Reprod Med Date: 2018-02-12
Authors: Ellen K Wilson; Kathleen E Krieger; Helen P Koo; Alexandra M Minnis; Katherine Treiman Journal: Contraception Date: 2014-03-06 Impact factor: 3.375
Authors: Étienne V Langlois; Malgorzata Miszkurka; Maria Victoria Zunzunegui; Abdul Ghaffar; Daniela Ziegler; Igor Karp Journal: Bull World Health Organ Date: 2015-04-01 Impact factor: 9.408