Journal Article

Dual needs: Contraceptive and sexually transmitted infection protection in Lusaka, Zambia

Context
Lusaka, Zambia, has both a high prevalence of HIV infection and relatively high contraceptive prevalence for Sub-Saharan Africa. In this context, family planning clinics have the potential to play an important role in the prevention of HIV and other sexually transmitted infections (STIs).

Methods
Data from a 1998 situation analysis of eight public-sector family planning clinics in Lusaka are used to measure the readiness of these clinics to provide STI prevention and diagnostic services. Observations of 2,452 client-provider interactions and data from interviews with 42 providers and 3,201 clients are used to look at the exchange of information on nonbarrier methods’ inability to protect against STIs. Finally, multivariate analysis is used to investigate the determinants of both having received that information and having retained it among users of methods other than the condom.

Results
Multivariate results indicate that clients who did not use condoms who were told that their method offers no protection against STIs had three times the odds of knowing this at their exit interview as did women who were not told that fact. Among clients who were informed by their provider, those with higher educational attainment, those whose providers had fewer years of schooling, and those attending smaller clinics were all more likely than other women to have correctly “received” the STI prevention message.

Conclusions
Although efforts are being made to integrate STI services into family planning clinics in Zambia, these efforts need reinforcement. The educational levels of both providers and their clients may be barriers to a successful transfer of STI prevention information during client-provider interactions.