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AIDS Research and Treatment
Volume 2013, Article ID 915923, 9 pages
http://dx.doi.org/10.1155/2013/915923
Research Article

Providers’ Perspectives on Provision of Family Planning to HIV-Positive Individuals in HIV Care in Nyanza Province, Kenya

1Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco General Hospital, 1001 Potrero Avenue, Ward 6D-14, San Francisco, CA 94110, USA
2Department of Obstetrics and Gynecology, The Warren Alpert Medical School of Brown University, Box G-A1, Providence, RI 02912, USA
3Centre for Microbiology Research, Kenya Medical Research Institute, P.O. Box 19464, Nairobi 00202, Kenya
4University of North Carolina School of Medicine, 4030 Bondurant Hall, Campus Box 7000, Chapel Hill, NC 27599, USA
5Ministry of Medical Services, Migori District Hospital, P.O. Box 202, Migori 40400, Kenya
6Ibis Reproductive Health, 1330 Broadway, Suite 1100, Oakland, CA 94612, USA

Received 16 July 2012; Accepted 26 March 2013

Academic Editor: Kelly Blanchard

Copyright © 2013 Sara J. Newmann et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective. To inform an intervention integrating family planning into HIV care, family planning (FP) knowledge, attitudes and practices, and perspectives on integrating FP into HIV care were assessed among healthcare providers in Nyanza Province, Kenya. Methods. Thirty-one mixed-method, structured interviews were conducted among a purposive sample of healthcare workers (HCWs) from 13 government HIV care facilities in Nyanza Province. Structured questions and case scenarios assessed contraceptive knowledge, training, and FP provision experience. Open-ended questions explored perspectives on integration. Data were analyzed descriptively and qualitatively. Results. Of the 31 HCWs interviewed, 45% reported previous FP training. Few providers thought long-acting methods were safe for HIV-positive women (19% viewed depot medroxyprogesterone acetate as safe and 36% viewed implants and intrauterine contraceptives as safe); fewer felt comfortable recommending them to HIV-positive women. Overall, providers supported HIV and family planning integration, yet several potential barriers were identified including misunderstandings about contraceptive safety, gendered power differentials relating to fertility decisions, staff shortages, lack of FP training, and contraceptive shortages. Conclusions. These findings suggest the importance of considering issues such as patient flow, provider burden, commodity supply, gender and cultural issues affecting FP use, and provider training in FP/HIV when designing integrated FP/HIV services in high HIV prevalence areas.