Integration of Family Planning Services into HIV Care and Treatment Services: A Systematic Review

June 2017 - Combination Prevention

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Haberlen, S.A., Narasimhan, M., Beres, L.K., and Kennedy, C.E. Studies in Family Planning (March 2017), e-publication ahead of print, doi:10.1111/sifp.12018.

Integrating family planning (FP) and HIV services is associated with increased knowledge and use of modern contraceptives and supports international targets for reproductive health and the 90-90-90 goals for HIV. The authors reviewed 14 eligible articles and characterized the range of models used to integrate FP into HIV care and treatment and synthesized evidence on integration outcomes among women living with HIV. Eligible studies all described facility-based models delivered in a range of facilities, from small health centers to large hospitals. In many models, HIV-positive peers delivered the FP information. Overall, integration was associated with higher knowledge and use of modern method contraceptives, although there was insufficient evidence to evaluate its effects on unintended pregnancy or achieving safe and healthy pregnancy. Most "one-stop shops" offered a wide range of contraceptive options, including short- and long-acting methods, but few offered female condoms or emergency contraception. Only a few studies measured the prevalence of dual contraceptive use to prevent pregnancy and HIV transmission. Providers' attitudes about respecting the fertility intentions of HIV-positive women improved in some studies, but overall remained negative. The authors concluded that especially where contraceptive use is low, integration must address community-wide and HIV-specific barriers to using effective FP methods while also improving access to information, commodities, and services within routine HIV care.

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