Adolescents Living With HIV: Contraceptive Services and Uptake in General Primary Healthcare Clinics and Stand-Alone Youth Clinics.

Abstract

To investigate whether current contraceptive uptake, unmet need for contraception, and unintended pregnancy among female adolescents living with HIV (ALHIV) vary with the model of access sites for HIV-related services, that is, stand-alone youth clinics (YCs) versus general primary health clinics (PHC). Exit interviews. Multi-center, primary healthcare facilities. Female adolescents living with HIV (ALHIV) aged 14-19 years and interviewed between March 1, 2017 and July 31, 2017. Structured exit paper-based survey. Participants were divided into stand-alone YC and general PHC groups. Uptake of contraceptive counseling and products were compared between the 2 clinic groups. A total of 303 female ALHIV completed the exit interviews. For female ALHIV, contraceptive prevalence was high among both general PHCs (84.2%) and stand-alone YCs (82.9%). Contraceptive method mix was similar between both groups of female ALHIV. Compared to stand-alone YCs, the general PHCs had similar likelihood of contraceptive counseling provision (aOR 0.84 95% CI [0.55, 1.26]) and provision of contraceptive products, including condoms (aOR 0.54 95% CI [0.26, 1.16]) and dual-method (aOR 1.80 95% CI [0.81, 3.99]) for female ALHIV. Also, there were no significant differences in the likelihood of contraceptive prevalence (aOR 0.99 95% CI [0.59, 1.67], unmet need for contraception (aOR 1.64 95% CI [0.90, 2.98]), and unintended pregnancy (aOR 1.06 95% CI [0.57, 1.98]) between clinic groups. Mainstreaming youth-friendly services into existing health facilities could achieve similar contraceptive service provision, uptake and outcomes for ALHIV as stand-alone youth clinics.