Overcoming Barriers to Family Planning through Integration: Perspectives of HIV-Positive Men in Nyanza Province, Kenya

Rachel L Steinfeld,Maricianah Onono,Craig R Cohen,Sara J Newmann,Daniel Grossman,Elizabeth A Bukusi

doi:10.1155/2013/861983

Rachel L Steinfeld, Maricianah Onono + Show 4 more

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https://doi.org/10.1155/2013/861983

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Abstract

This study explored barriers to and facilitators of using family planning services among HIV-positive men in Nyanza Province, Kenya. From May to June 2010, in-depth interviews were conducted with 30 men receiving care at 15 HIV clinics. The key barriers to the use of family planning included concerns about side effects of contraceptives, lack of knowledge about contraceptive methods, myths and misconceptions including fear of infertility, structural barriers such as staffing shortages at HIV clinics, and a lack of male focus in family planning methods and service delivery. The integration of family planning into HIV clinics including family planning counseling and education was cited as an important strategy to improve family planning receptivity among men. Integrating family planning into HIV services is a promising strategy to facilitate male involvement in family planning. Integration needs to be rigorously evaluated in order to measure its impact on unmet need for contraception among HIV-positive women and their partners and assure that it is implemented in a manner that engages both men and women.

Highlights

Many studies have demonstrated the diversity and complexity of reproductive intentions among people living with HIV in sub-Saharan Africa, which are influenced by personal, health-related, sociocultural, socioeconomic, and gendered factors [1,2,3,4,5,6]
Despite commonly cited barriers to uptake and use of contraception, such as insufficient knowledge about contraceptive methods, fear of social disapproval, and fear of side-effects and health concerns [24,25,26], we found that most men in this exploratory study felt that integrating family planning into HIV care would be a preferable way to receive family planning information and services compared to separate services at the maternal and child health or family planning clinics
We found that many expressed a desire to learn more about family planning and felt that integrating family planning into HIV services would increase their knowledge about and involvement in family planning

Summary

Introduction

Many studies have demonstrated the diversity and complexity of reproductive intentions among people living with HIV in sub-Saharan Africa, which are influenced by personal, health-related, sociocultural, socioeconomic, and gendered factors [1,2,3,4,5,6]. Some HIV-positive individuals believe that having children gives them reasons to live [1, 7, 8], and some bear children to avoid raising suspicions of HIV infection [8, 9]. Many HIV-positive individuals want to avoid pregnancy due to financial reasons and being satisfied with the number of children they have [6]. Several studies have shown that fertility desires differ by gender, that one partner’s fertility intentions can impact the other’s, and that men and women are influenced differently by community opinions regarding HIV and reproduction [1, 5, 8, 11, 12]

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