ASSOCIATION OF FAMILY PLANNING INTEGRATION WITH CONTRACEPTIVE UPTAKE IN KENYAN HIV TREATMENT CENTERS

Thesis (Master's)--University of Washington, 2018Objective: To assess facility-level integration of family planning (FP) into HIV care and contraceptive use among HIV-infected women on antiretroviral therapy (ART). Study design: We conducted a national cross-sectional study with key informants and HIV-infected women on ART to assess integration of FP into HIV care at 108 HIV care and treatment centers with >1000 ART clients per year. Separate surveys were administered to key informants and HIV-infected women. We classified facilities offering FP services in the same facility as care as integrated facilities. Results: Overall, 108 facilities throughout Kenya were evaluated, and 4748 HIV-infected women were enrolled. The majority (73%) of facilities offered integrated FP services. Integrated facilities were more common in the Nyanza region than Nairobi (77% vs 35% respectively, p=0.06). Integrated FP services were more likely to be offered in public compared to private facilities [PR: 1.86, 95% CI: 1.11-3.11; p=0.02]. Contraceptive use [modern contraception, dual FP method, and long-acting reversible contraception (LARC) and non-barrier short-term methods] were significantly higher in facilities that offered integrated FP services (p