Impact of Integrated Family Planning and HIV Care Services on Contraceptive Use and Pregnancy Outcomes: A Retrospective Cohort Study
Kosgei, R. J., Lubano, K. M., Shen, C., et al. Journal of Acquired Immune Deficiency Syndromes (2011), Vol. 58 No. 5, pp. e121-126.
The United States Agency for International Development-Academic Model Providing Access to Healthcare (AMPATH) Partnership in Kenya assessed a pilot program intended to increase HIV-positive women’s use of family planning (FP) methods. The study measured differences between routine care (RC) and an integrated family planning services (IFP) model to determine the effect of additional FP services in HIV care on use of modern contraceptive methods and pregnancy rates. The AMPATH site was in a hospital in Eldoret, Kenya, where more than 17,000 adult patients were receiving HIV care. In RC, two groups of patients totaling 2,578 received FP services, including condom counseling and availability as a means to reduce HIV transmission. In IFP, 1,453 patients received RC in addition to FP services. It was found that in the IFP group that the incidence of new condom use increased, as did use of new FP methods including condoms; and the incidence of new FP use excluding condoms decreased. There was no statistical difference in the number of new pregnancies in the IFP group. Findings on the attributable risk of the incidence rate per 100-person-years of IFP and RC followed similar trends. The study demonstrates that an IFP model can be successful in HIV care sites.