The effect of integrating counseling and testing of HIV within family planning settings on sexual behavior and fertility intentions
Presentation at the 5th International AIDS Society (IAS) Conference on HIV Pathogenesis, Treatment and Prevention, Cape Town, 19-22 July
Khoza,Doctor; Mullick,Saiqa; Menziwa,Mantshi; Maroga,Edwin
Publication date: 2009
In South Africa, counseling and testing for HIV (C&T) is mainly limited to antenatal care settings and stand-alone centers. Family planning (FP) services, on the other hand, are well established with high rates of utilization. Prevalence rates of STI and HIV infections are often quite high among FP clients, and FP consultation is frequently a missed opportunity for providers to integrate information about other services. To address this gap the Population Council in collaboration with the North West Department of Health (NWDoH) is evaluating a model of integrating C&T into family planning settings.
Twelve clinics were randomly selected and assigned to six interventions and six comparisons. FP providers in the intervention sites were trained to discuss HIV risk and prevention and routinely offer testing for HIV using Balance Counseling Strategy Plus. 319 family planning clients were interviewed after FP consultation at baseline and followed up 12 months post-intervention.
Post-intervention dual protection from intervention clinics increased from 50 percent to 58 percent (p= 0.183) while in control clinics a decline in percentage was observed, 48 percent to 42 percent. Condom use at last sex increased post-intervention from 29 percent to 48 percent (p =0.000) while in control sites a decline was seen from 38 percent to 32 percent. Always using condoms with main partner increased from 22 percent to 50 percent (p= 0.000) post, and a slight decrease in control clinics was observed, 36 percent to 34 percent. Having had multiple sexual partners declined from 14 percent to 7 percent (p=0.055) in intervention clinics, and 6 percent to 3 percent in control clinics. Intentions to have a child in the future decreased from 41 percent to 28 percent (p=0.014) from the intervention clinics and 38 percent to 25 percent (p=0.015) in control clinics.
The findings suggest that integration of HIV prevention and testing into FP services could be an important strategy to prevent new infections and identify new infections early.