Integration of family planning services into health care for HIV‐positive women in Botswana

Hawkins, Lois; Gertz, Alida M.; Badubi, Opelo; Sickboy, Ontiretse; Mussa, Aamirah; Maotwe, Tshego; Whittaker, Paul; Schreiber, Courtney A.; Ramagola-Masire, Doreen; Morroni, Chelsea

doi:10.1002/ijgo.13464

Cited by 6 publications

(7 citation statements)

References 19 publications

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“…Pertaining the method of contraception, the main method of contraception was injectable contraceptives (45.8%) because it's easy to use, administer, and can be used without the partner's knowledge as well as easy follow up which is once every 3 months. This is consistent with the findings of a similar study conducted in South Africa by [22] who reported that women were interested in using injectable because it can be used without their partners' awareness and injectable has less tension than pills like swallowing and remembering of timing of pills swallowing.…”

Section: Service Delivery Factors Influencing the Utilization Of Fp Services By Plwhiv Attending Taso Masakasupporting

confidence: 91%

Family Planning Utilization among PLWHIV Attending TASO Masaka: Evidence from a Cross-Sectional Study

et al. 2021

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People living with HIV (PLWHIV) need family planning (FP) services to avert the spread of HIV and eliminate mother to child transmission (MTCT). Besides, family planning services greatly reduce the incidence of vertical transmission reducing new cases of pediatric infections. The aim of this study was to establish the factors influencing the utilization of FP services among PLWHIV affiliated to The AIDS Service Organization (TASO) Masaka responsible for the unmet need for FP utilization. A cross-sectional study with quantitative data analysis was used. A structured questionnaire was used to collect data in line with the set objectives. Categorical data were presented as frequency percent and continuous data as a mean ±standard deviation. The data were analyzed with the statistical software called Medcalc software v. 19.5.6. Analysis was done using the test of proportion at 95% confidence interval and a P<0.05 was considered statistically significant. The study had significantly more females, married, and of low education level (p<0.05). Medium parity of 1-3, a spouse being comfortable with a partner using FP, knowledge about FP were significantly associated with FP use (P<0.05). The Majority of the participants were using FP methods (P<0.05) with injections being the most used method (P<0.05). The Majority of the clients would encourage others to use FP (P<0.05) and HIV had no effect on FP use (P<0.05). Culture and society beliefs did not affect FP utilization (P<0.05). Being close to the service provider, hospitality of the service provider, information about the benefits and risks associated with FP use were significantly associated with utilization of FP methods (P<0.05). However, the overall utilization of FP was low (58.9%) and was largely affected by personal factors other than community or service delivery factors. Future research should focus on the putative personal factors that may prevent the utilization of FP methods.

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Section: Service Delivery Factors Influencing the Utilization Of Fp Services By Plwhiv Attending Taso Masakasupporting

confidence: 91%

Family Planning Utilization among PLWHIV Attending TASO Masaka: Evidence from a Cross-Sectional Study

et al. 2021

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“…Description of studies : Seventeen studies were included in the systematic review: four RCTs and one two-year follow up analysis of an RCT 18 35 36 37 38 , two non-RCTs 39 40 , six pre-post-intervention studies 41 42 43 44 45 46 , one cohort study 47 and three cross-sectional comparison studies 48 49 50 . Among these studies, 15 belonged to African countries: four from Kenya 36 38 47 50 and two from South Africa 35 42 , Uganda 37 48 and Malawi 44 49 .…”

Section: Resultsmentioning

confidence: 99%

“…Among these studies, 15 belonged to African countries: four from Kenya 36 38 47 50 and two from South Africa 35 42 , Uganda 37 48 and Malawi 44 49 . One study each belonged to Zimbabwe 39 , Nigeria 40 , Tanzania 41 , Botswana 45 and Zambia 46 . Apart from the African countries, one study each belonged to India 18 and the United Kingdom 43 .…”

Section: Resultsmentioning

confidence: 99%

Health facility-based interventions and the uptake of contraception among people living with HIV: A systematic review & meta-analysis

Revathy,

Chaurasia,

Shetty

et al. 2023

Indian Journal of Medical Research

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Background & objectives: The prong 2 of 4 prong strategy introduced by the World Health Organization aims at averting unintended pregnancies among people living with HIV (PLHIV). This systematic review aimed to generate evidence on the effectuality of facility-based interventions in improving uptake of modern and dual contraception, for reducing unmet family planning (FP) needs and unintended pregnancies among PLHIV. Methods: Articles evaluating facility-based interventions to integrate human immunodeficiency virus (HIV) and FP published in English language were included. Eligible studies were identified from electronic and lateral search from three databases (PubMed, Cochrane Library and Web of Science) and grey literature. HIV care with no/minimal focus on FP was considered a comparator. Quality was assessed using design-appropriate tools. Descriptive analysis was presented in tables. Uptake of dual methods, unmet FP needs and unintended pregnancies were included in the meta-analysis to estimate pooled odds ratio (OR) with random effect model, P and I 2 values. Results: The search yielded 2112 results. After excluding duplicates and unfit articles, 17 were found eligible for review and nine for meta-analysis. The pooled OR for uptake of dual contraception was 1.69 (1.14, 2.5) (P=0.008; I 2=90%), for unmet FP needs was 0.58 (0487, 0.69) (P<0.00001; I 2=0%) and for unintended pregnancies was 0.6 (0.32, 1.1) (P=0.1, I 2=38%). Interpretation & conclusions: The results of this meta-analysis suggest that health facility-based interventions to integrate HIV and FP services do result in improved uptake of dual methods and reduce unmet need for contraception along with a protective trend on incidence of unintended pregnancies. Such facility-based integration would ensure universal access to effective contraception and facilitate in achieving Sustainable Development Goals that aim at ending epidemics like HIV.

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“…Hawkins et al reported on women's desire for wanting to utilize LARC pre-intervention compared to post-intervention ( 37 ). A positive association between integration and more positive attitudes toward FP was identified with the desire to use LARC at 6% at pre-intervention compared to 29% at the endpoint ( p < 0.001) ( 37 ).…”

Section: Resultsmentioning

confidence: 99%

The Effect of Integration of Family Planning Into HIV Services on Contraceptive Use Among Women Accessing HIV Services in Low and Middle-Income Countries: A Systematic Review

Grant-Maidment¹,

Kranzer²,

Ferrand³

2022

Front. Glob. Womens Health

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There is substantial unmet need for family planning (FP) among women living with HIV (WLHIV), leading to unintended pregnancies and may contribute indirectly to increasing the risk of transmission of HIV. This review aims to determine whether integration of FP into HIV testing and care results in increased use of contraception, a reduction in unmet need for FP, improved use of safer conception methods and a reduction in unintended pregnancies in low and middle-income countries. A systematic review was undertaken incorporating studies from PubMed, EMBASE, CINAHL, Web of Science and Global Health, the International AIDS Society Abstract Archive, the World STI & HIV Congress Abstract Archive and the Conference on Retroviruses and Opportunistic Infections Abstract Archive published between 2016 and 2021, updating previous systematic reviews. After screening, 13 studies were included, 11 conducted in sub-Saharan Africa and 2 in India. The primary outcome of the review was contraceptive uptake and secondary outcomes included unmet need for FP, safer conception and unintended pregnancy. Integrated FP-HIV facilities were found to increase dual contraceptive use by at least 8% in five studies and modern contraceptive use by at least 8% in four studies. Findings from two studies suggested integration decreased the unmet need for contraception. Limited data prevented a conclusion from being drawn regarding whether integration increases safer conception. There was no evidence of integration reducing unintended pregnancies. The median quality score of studies was 3/9. Overall, integrated facilities have the potential of improving reproductive health of women accessing HIV services in LMICs. FP may be enhanced by including a safer conception component for WLHIV.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021251008, identifier: CRD42021251008.

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Integration of family planning services into health care for HIV‐positive women in Botswana

Abstract: In an HIV clinic in Botswana, provision of on-site contraceptive services for women encouraged family planning discussions and increased interest in LARC.

Cited by 6 publications

References 19 publications

Family Planning Utilization among PLWHIV Attending TASO Masaka: Evidence from a Cross-Sectional Study

Family Planning Utilization among PLWHIV Attending TASO Masaka: Evidence from a Cross-Sectional Study

Health facility-based interventions and the uptake of contraception among people living with HIV: A systematic review & meta-analysis

The Effect of Integration of Family Planning Into HIV Services on Contraceptive Use Among Women Accessing HIV Services in Low and Middle-Income Countries: A Systematic Review

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