scholarly journals Integration of HIV Prevention With Sexual and Reproductive Health Services: Evidence for Contraceptive Options and HIV Outcomes Study Experience of Integrating Oral Pre-exposure HIV Prophylaxis in Family Planning Services in Lusaka, Zambia

2021 ◽  
Vol 3 ◽  
Author(s):  
Margaret Phiri Kasaro ◽  
Ntazana Sindano ◽  
Manze Chinyama ◽  
Mayaba Mudenda ◽  
Florence Chilaisha ◽  
...  
Keyword(s):  
Family Planning ◽  
Hiv Prevention ◽  
Reproductive Health ◽  
Sexual And Reproductive Health ◽  
Assessment Tool ◽  
Reproductive Health Services ◽  
District Health ◽  
Treatment And Prevention ◽  
Study Experience ◽  
Oral Prep

The WHO guideline on the integration of family planning (FP) and pre-exposure HIV prophylaxis (PrEP) to enhance the health of women and adolescent girls is reflected in the Zambia Consolidated Guidelines for Treatment and Prevention of HIV Infection, 2020. There is however a dearth of data on the integration of PrEP and FP in Zambia. We describe the integration of oral PrEP in FP services using the Evidence for Contraceptive Options and HIV Outcomes (ECHO) study experience at Kamwala District Health Center in Lusaka, Zambia. The provision of oral PrEP at Kamwala started in October 2017, lasting for ~11 months, and utilized the model where initial processes to offer PrEP were on-site followed by off-site referral to laboratory and PrEP provider services. The characteristics of 658 women who enrolled in ECHO at Kamwala are representative of women accessing FP services in Lusaka. About 644 of the enrollees were offered oral PrEP. The proportion of women accepting PrEP was low at 1.08% and the proportion of study visits at which PrEP was requested was also low at 0.57%. Those who accepted PrEP were above 20 years old, married, with at least primary education, sexual behavior, and risk comparable to decliners. The ECHO study experience indicates that the setup and integration of oral PrEP and FP services are feasible in the setting. However, uptake of PrEP was very low. Possible contributory factors were as follows: (1) timing of introduction of PrEP midway in the study, (2) PrEP being a new intervention, (3) challenges of autonomy of young women to include a daily pill into their lives and anticipated challenges to adherence because of fear of adverse events, (4) possible underdetermined risk due to use of an unvalidated risk assessment tool and assessment by health care provider vs. self-assessment, and (5) extra layer of challenges to negotiate due to needing for off-site referrals. Following these findings, we conclude that further research through demonstration projects of integration of oral PrEP and FP may provide solutions to low uptake. This information is critical for scaling up of integration HIV prevention services and sexual and reproductive health (SRH) services.

scholarly journals Integration of HIV prevention into Sexual and Reproductive Health Services in an urban setting in South Africa

2013 ◽  
Vol 5 (1) ◽  
Author(s):  
Shireen Parker ◽  
Vera Scott
Keyword(s):  
Family Planning ◽  
Hiv Prevention ◽  
Reproductive Health ◽  
Health Services ◽  
Sexual And Reproductive Health ◽  
Cape Town ◽  
Hiv And Aids ◽  
Urban Setting ◽  
Reproductive Health Services ◽  
Family Planning Services

Background: The United Nations Political Declaration on HIV and AIDS of 2006 stressed the need to strengthen policy and programme linkages between HIV and Sexual and Reproductive Health (SRH). However, the effectiveness and best practices for strengthening SRH and HIV linkages are poorly researched in the context of family-planning services. In Cape Town, HIV-prevention services have been integrated into family-planning services. There are two models of service configuration: dedicated stand-alone reproductive health clinics and family planning services located in comprehensive primary-care facilities.Objective: To describe how reproductive health services are integrating HIV prevention and care strategies and to measure the coverage and quality of these integrated services.Methods: A cross-sectional study was conducted using structured interviews with facility managers; a facility-based checklist; and a patient record review to assess the availability of resources, training, access, quality and integration.Results: Facilities in Cape Town are equipped adequately to offer integrated HIV-prevention and SRH services. Overall there was poor coverage of integrated services with 54% of family planning clients having a known HIV status; 47% being screened for a sexually transmitted infection and 55% being offered HIV counselling and testing and receiving condoms. Quality and continuity of care seemed better at the dedicated clinics than at the comprehensive facilities,supported by better training coverage.Conclusion: Engaging middle-level management is crucial with regard to improving integration within a well-resourced setting.

scholarly journals Quick and collaborative response to teenage pregnancies in a poor semi-rural area of Belgium

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
V Déom ◽  
L Ben Abdelhafidh ◽  
N Annez ◽  
C Glorie ◽  
M Roland
Keyword(s):  
Family Planning ◽  
Reproductive Health ◽  
Rural Areas ◽  
Sexual And Reproductive Health ◽  
Health Clinic ◽  
Local Health ◽  
Reproductive Health Services ◽  
Sexually Transmitted ◽  
Victims Of Violence ◽  
The City

Abstract Early pregnancies are often linked to precarious situations. Even if Belgium has seen a decrease in teenage pregnancies, in the former mining region of the Hainaut there are still twice as many births to young women under 20 compared to the national rate. Colfontaine is one of the poorest cities in Belgium. Last year, one of the local high schools counted 10 pregnant teenagers out of 450 students. Médecins du Monde was already present in the city at the time with a mobile health clinic called the Médibus. In response, we carried out a mapping of the local sexual and reproductive health actors. The lack of accessibility to social and health structures capable of welcoming teenagers anonymously and free of charge quickly emerged as a problem, the nearest family planning center being located 30 minutes away by bus. In September 2019, in partnership with 5 local health actors, we decided to reshape the Médibus into the Adobus in order to offer family planning consultations, health promotion and harm reduction activities at the high school once a week. In addition to offering health information services, we also aim to detect teenagers experiencing vulnerable situations such as addiction, violence, gender issues and refer them to appropriate services. Halfway through the project, we met 430 teenagers in 14 afternoons. The most common reasons for consultation (N = 310) were questions related to contraception for 29% and to sexually transmitted infections for 24,5%. 70,9% of teenagers received condoms and 13 girls were tested for pregnancy. One girl received a morning-after pill. 3 teenagers with addiction problems and 17 victims of violence were detected. The teams referred 18 teenagers to other services. The success of this outreach project confirms the need for information regarding sexual and reproductive health for teenagers living in precarious situations as well as the need to develop reachable and affordable sexual and reproductive health services in semi-rural areas. Key messages Outreach is an efficient approach to respond to teenagers’ needs in poor semi-rural areas. Outreach facilitated the detection of early pregnancies, addiction and violence issues among teenagers.

scholarly journals Ejercicio de derechos a la salud sexual y reproductiva entre mujeres de 20-29 años en Panamá y factores asociados.[Sexual and reproductive health rights exercise among women aged 20-29 in Panama and associated factors.]

2021 ◽  
Vol 40 (03) ◽  
Author(s):  
Fermina Chamorro Mojica ◽  
Faride Rodriguez ◽  
Selvis Stocel ◽  
Ruth De León
Keyword(s):  
Family Planning ◽  
Hiv Prevention ◽  
Reproductive Health ◽  
Associated Factors ◽  
Sexual And Reproductive Health ◽  
Prevención Del Vih ◽  
Conjugal Violence ◽  
Modern Contraceptives ◽  
Professional Care ◽  
Health Rights

<p>Introducción: Los derechos a la salud sexual y reproductiva (DSSR) son básicos, y la capacidad de las mujeres para ejercerlos influye en lograr objetivos de desarrollo. Objetivos: Estimar indicadores de DSSR en mujeres de 20-29 años identificando factores asociados. Métodos: Con datos de la Encuesta Nacional de Salud Sexual y Reproductiva 2014-2015 se analizaron 1206 casadas/unidas (982 con demanda de planificación familiar, 1082 con hijos, y 978 usuarias de anticonceptivos), midiéndose la violencia conyugal en el último año, conocimiento sobre prevención del VIH, demanda satisfecha con anticonceptivos modernos, atención profesional al parto y autonomía. Se utilizó la regresión logística multivariada para probar asociaciones. Resultados: Padeció violencia conyugal 13.0%, tenía conocimiento sobre prevención del VIH 38.8%, satisfacía su demanda de planificación familiar con métodos modernos 62.0%; recibió atención profesional al parto 81.1%; y mostró autonomía 10.3%. Las oportunidades relativas ajustadas (ORa) de violencia conyugal eran mayores en mujeres que la justificaban ORa=1.92;IC95%:1.09-3.39); el conocimiento sobre prevención del VIH aumentaba con la escolaridad (ORa=1.13;IC95%:1.04-1.22); la satisfacción de la demanda con métodos modernos era menor si justificaban la violencia conyugal (ORa=0.42; IC95%:0.20-0.85) y mayor en aquellas con una mayor percepción de empoderamiento (ORa=2.33;IC95%:1.15-5.00). Las ORa de atención profesional en el último parto disminuyen cuando aumentaba la edad (ORa=0.72;IC95%:0.62-0.84), y era menor si experimentaron matrimonio infantil (ORa=0.43;IC95%:0.19-0.95). Las ORa de mayor autonomía resultaron menores en casadas (ORa=0.22;IC95%:0.10-0.47) y amas de casa (ORa=0.53;IC95%:0.28-0.98). Conclusiones: El ejercicio de DSSR y sus factores asociados constituyen desafíos al diseño de políticas públicas.</p><p>Abstract</p><p>Introduction: Sexual and reproductive health rights (SRHR) are basic, and women capacity to exert them influence achieving development goals. Objectives: Estimate indicators of SRHR in women aged 20-29 years, identifying associated factors. Methods: A total of 1206 married/cohabitant women (908 with need for family planning, 1082 with children and 978 contraceptive users) were analyzed with data from National Sexual and Reproductive Health Survey 2014-2015. It was obtained the proportion of conjugal violence victims in the last year, with knowledge about VIH prevention, family planning needs satisfied by modern contraceptive methods, with professional care at delivery and with autonomy. Multivariate logistic regression was used to test associations. Results: The 13.0% of women suffered conjugal violence, 38.8% had knowledge about HIV prevention, 62.0% used modern contraceptives for satisfying family planning needs, 81.1% received professional care at delivery, and 30.7% made informed decisions about SRH. Adjusted odds ratio (AOR) for conjugal violence were greater when women justified violence (AOR=1.92;95%CI:1.09-3.39); knowledge about HIV prevention increases with schooling (AOR=1.13;95%CI:1.04-1.22); family planning met with modern contraceptives methods was lower, if they justified violence (AOR=0.42;95%CI 0.20-0.85) and higher in women with a higher empowerment perception (AOR=2.33;95%CI:1.15-5.00). The AOR for professional care at last delivery decrease with increasing age (AOR=0.72;95%CI:0.62-0.84) and was lower if they experienced child marriage (AOR=0.43;95%CI:0.19-0.95). The AOR for autonomy was lower in married women (AOR=0.22;95%CI:0.10-0.47) and housewives (AOR=0.53;95%CI:0.28-0.98). Conclusions: The exert of SRHR and its associated factors challenge public policies design.</p>

scholarly journals “The Financial Is the Main Issue, It’s Not Even the Child”: Exploring the Role of Finances in Men’s Concepts of Fatherhood and Fertility Intention

2018 ◽  
Vol 12 (4) ◽  
pp. 1074-1083 ◽  
Author(s):  
Megan Hamm ◽  
Elizabeth Miller ◽  
Lovie Jackson Foster ◽  
Mario Browne ◽  
Sonya Borrero
Keyword(s):  
Family Planning ◽  
Reproductive Health ◽  
Health Services ◽  
Low Income ◽  
Financial Stability ◽  
Sexual And Reproductive Health ◽  
Contraceptive Use ◽  
Fertility Intention ◽  
Reproductive Health Services ◽  
Family Planning Services

Despite demonstrable need, men’s utilization of sexual and reproductive health services remains low. This low utilization may particularly affect low-income men, given the disproportionate prevalence of unintended pregnancy in low-income populations. Bolstering men’s utilization of sexual and reproductive health services requires understanding the services that are most relevant to them. Semistructured interviews about fatherhood, fertility intention, and contraceptive use were conducted with 58 low-income Black and White men in Pittsburgh, Pennsylvania. The interviews were analyzed using content analysis to determine common themes that were most relevant to the men interviewed. The primacy of financial stability emerged as a dominant theme in men’s perceptions of fatherhood readiness, successful fathering, and fertility intentions. However, men had children despite feeling financially unprepared, and their contraceptive use was not always congruent with their stated fertility intentions. Some men described financial services as a feature of family planning services that they would find useful. Because of the salience of financial stability in preparation for fatherhood, integrating financial counseling and job skills training into the context of sexual and reproductive health services could be a useful structural intervention to increase men’s use of family planning services and to provide them with the support they say they need as fathers.

scholarly journals Opinions of Health Professionals on Tailoring Reproductive Health Services to the Needs of Adolescents

2018 ◽  
Vol 2018 ◽  
pp. 1-7
Author(s):  
Ellen Abrafi Boamah-Kaali ◽  
Seyram Kaali ◽  
Grace Manu ◽  
Stephaney Gyaase ◽  
Elisha Adeniji ◽  
...  
Keyword(s):  
Reproductive Health ◽  
Health Services ◽  
Health Professionals ◽  
Sexual And Reproductive Health ◽  
Service Providers ◽  
Unwanted Pregnancy ◽  
Health Programs ◽  
Reproductive Health Services ◽  
District Health ◽  
Sexually Transmitted

Introduction. Tailoring sexual and reproductive health programs and services to the needs of adolescents will help adolescents make informed decisions and choices regarding their sexual and reproductive health. Objective. To assess the opinions of service providers on tailoring sexual and reproductive health services to the needs of adolescents. Method. A qualitative study using indepth interviews was held among eight decision-makers and service providers in two hospitals within the Kintampo North Municipality and Kintampo South District as well as the Municipal and District Health Directorates in Kintampo North and South between April and May 2011. Results. All respondents expressed the opinion that it is a good idea to tailor sexual and reproductive health services to the needs of adolescents. They admitted that very limited sexual and reproductive health programs targeting adolescent needs were available in the study area. Service providers also reported very low levels of health facilities use by adolescents for sexual and reproductive health information and services. Health professionals attributed the poor sexual and reproductive health services utilization by adolescents to stigma from the society and attitudes of service providers. Conclusion. There are no targeted sexual and reproductive health programmes and services for adolescents. Services providers indicated that it is important to tailor sexual and reproductive health services to the needs of adolescents to prevent stigma, unwanted pregnancy, abortion, and sexually transmitted infections.

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