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

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 i...

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Main Authors: Sara J. Newmann, Kavita Mishra, Maricianah Onono, Elizabeth A. Bukusi, Craig R. Cohen, Olivia Gage, Rose Odeny, Katie D. Schwartz, Daniel Grossman
Format: Article
Language:English
Published: Wiley 2013-01-01
Series:AIDS Research and Treatment
Online Access:http://dx.doi.org/10.1155/2013/915923
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author Sara J. Newmann
Kavita Mishra
Maricianah Onono
Elizabeth A. Bukusi
Craig R. Cohen
Olivia Gage
Rose Odeny
Katie D. Schwartz
Daniel Grossman
author_facet Sara J. Newmann
Kavita Mishra
Maricianah Onono
Elizabeth A. Bukusi
Craig R. Cohen
Olivia Gage
Rose Odeny
Katie D. Schwartz
Daniel Grossman
author_sort Sara J. Newmann
collection DOAJ
description 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.
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spelling doaj-art-68cd0e4e20b44846aba372ed4c792a062025-08-20T03:33:31ZengWileyAIDS Research and Treatment2090-12402090-12592013-01-01201310.1155/2013/915923915923Providers’ Perspectives on Provision of Family Planning to HIV-Positive Individuals in HIV Care in Nyanza Province, KenyaSara J. Newmann0Kavita Mishra1Maricianah Onono2Elizabeth A. Bukusi3Craig R. Cohen4Olivia Gage5Rose Odeny6Katie D. Schwartz7Daniel Grossman8Department 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, USADepartment of Obstetrics and Gynecology, The Warren Alpert Medical School of Brown University, Box G-A1, Providence, RI 02912, USACentre for Microbiology Research, Kenya Medical Research Institute, P.O. Box 19464, Nairobi 00202, KenyaDepartment 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, USADepartment 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, USAUniversity of North Carolina School of Medicine, 4030 Bondurant Hall, Campus Box 7000, Chapel Hill, NC 27599, USAMinistry of Medical Services, Migori District Hospital, P.O. Box 202, Migori 40400, KenyaDepartment 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, USADepartment 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, USAObjective. 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.http://dx.doi.org/10.1155/2013/915923
spellingShingle Sara J. Newmann
Kavita Mishra
Maricianah Onono
Elizabeth A. Bukusi
Craig R. Cohen
Olivia Gage
Rose Odeny
Katie D. Schwartz
Daniel Grossman
Providers’ Perspectives on Provision of Family Planning to HIV-Positive Individuals in HIV Care in Nyanza Province, Kenya
AIDS Research and Treatment
title Providers’ Perspectives on Provision of Family Planning to HIV-Positive Individuals in HIV Care in Nyanza Province, Kenya
title_full Providers’ Perspectives on Provision of Family Planning to HIV-Positive Individuals in HIV Care in Nyanza Province, Kenya
title_fullStr Providers’ Perspectives on Provision of Family Planning to HIV-Positive Individuals in HIV Care in Nyanza Province, Kenya
title_full_unstemmed Providers’ Perspectives on Provision of Family Planning to HIV-Positive Individuals in HIV Care in Nyanza Province, Kenya
title_short Providers’ Perspectives on Provision of Family Planning to HIV-Positive Individuals in HIV Care in Nyanza Province, Kenya
title_sort providers perspectives on provision of family planning to hiv positive individuals in hiv care in nyanza province kenya
url http://dx.doi.org/10.1155/2013/915923
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