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Unmet need for family planning and low rates of dual method protection among men and women attending HIV care and treatment services in Kenya, Namibia.

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Presentation on theme: "Unmet need for family planning and low rates of dual method protection among men and women attending HIV care and treatment services in Kenya, Namibia."— Presentation transcript:

1 Unmet need for family planning and low rates of dual method protection among men and women attending HIV care and treatment services in Kenya, Namibia and Tanzania Mbatia R, Antelman G, Pals S, Bachanas P, Carpenter D, DeLuca N, Muhenje O, Sheriff M, Arthur G, Elul B and the ‘HIV Prevention for PLHIV: Evaluation of an Intervention Toolkit for HIV Care and Treatment Settings’ Study Team

2 Methods Data Source Baseline data from the ‘Prevention in Care and Treatment Settings’ group randomized intervention trial assessing integrated HIV prevention into care and treatment services at 18 HIV clinics in Kenya, Namibia, Tanzania (6 per country) Analytic sample Participants eligible for inclusion were n=3475 men (n=1483) and women < 50 years (n=1992) living with HIV, sexually active, attending care and treatment (not couples, not pregnant) Interviewed between Oct 2009-Mar 2010

3 1.Discussed FP with health care worker in the HIV clinic 2.Unmet need for FP: Not desiring pregnancy in next 6 months & not using any FP method 3.Unmet need for dual method: Not desiring pregnancy in next 6 months, & not using condoms plus a highly effective FP method  All self reported by client Outcomes

4 Number and proportion of men and women who report a health care provider talked to them about family planning in the HIV clinic 46% of women compared to 28% of men, overall countries, talked to a provider about FP; gender differences in all countries were statistically significant

5 Unmet need for FP and dual protection among respondents not desiring pregnancy Unmet need for dual method -- below the green bars

6 Discussion  In summary, high levels of condom use were reported and high unmet need for dual method was observed.  HIV-positive clients may over-report condom use. If so, actual unmet need for FP is severely under-estimated.  Over-reported condom use may be a barrier to identification of unmet need for effective pregnancy prevention.

7 HEALTH CARE PROVIDERS 1.Give basic prevention recommendations: disclosure, partner testing, safer sex, and alcohol reduction 2.Assess and support adherence 3.Provide family planning and safer pregnancy counseling 4.Assess and treat STI symptoms 5.Distribute condoms HEALTH CARE PROVIDERS 1.Give basic prevention recommendations: disclosure, partner testing, safer sex, and alcohol reduction 2.Assess and support adherence 3.Provide family planning and safer pregnancy counseling 4.Assess and treat STI symptoms 5.Distribute condoms Refer for behavioral prevention counseling, positive living, adherence, and alcohol reduction Refer for provision of family planning, pregnancy advice and STI management LAY COUNSELORS 1. Conduct Group Education Basic Education on HIV/AIDS Protecting Your Partner Protecting Your Children Treatment Adherence Positive Living 2.Provide Individual Counseling 3.Provide HIV Counseling and Testing, where permitted Individuals (both walk-in and partner(s) of clinic patients) Couples (concordant and discordant) LAY COUNSELORS 1. Conduct Group Education Basic Education on HIV/AIDS Protecting Your Partner Protecting Your Children Treatment Adherence Positive Living 2.Provide Individual Counseling 3.Provide HIV Counseling and Testing, where permitted Individuals (both walk-in and partner(s) of clinic patients) Couples (concordant and discordant) PiCTS study intervention package


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