title: Impact of integrated family planning and HIV care services on contraceptive use and pregnancy outcomes: a retrospective cohort study.
abstract: OBJECTIVE
  To determine the impact of routine care (RC) and integrated family planning (IFP) and HIV care service on family planning (FP) uptake and pregnancy outcomes.
  
  
  METHODS
  Retrospective cohort study conducted between October 10, 2005, and February 28, 2009.
  
  
  METHODS
  United States Agency for International Development-Academic Model Providing Access To Healthcare (USAID-AMPATH) in western Kenya.
  
  
  METHODS
  Records of adult HIV-infected women.
  
  
  METHODS
  Integration of FP into one of the care teams. PRIMARY OUTCOMES MEASURES: Incidence of FP methods and pregnancy.
  
  
  RESULTS
  Four thousand thirty-one women (1453 IFP; 2578 RC) were eligible. Among the IFP group, there was a 16.7% increase (P < 0.001) [95% confidence interval (CI): 13.2% to 20.2%] in incidence of condom use, 12.9% increase (P < 0.001) (95% CI: 9.4% to 16.4%) in incidence of FP use including condoms, 3.8% reduction (P < 0.001) (95% CI: 1.9% to 5.6%) in incidence of FP use excluding condoms, and 0.1% increase (P = 0.9) (95% CI: -1.9% to 2.1%) in incidence of pregnancies. The attributable risk of the incidence rate per 100 person-years of IFP and RC for new condom use was 16.4 (95% CI: 11.9 to 21.0), new FP use including condoms was 13.5 (95% CI: 8.7 to 18.3), new FP use excluding condoms was -3.0 (95% CI: -4.6 to -1.4) and new cases of pregnancies was 1.2 (95% CI: -0.6 to 3.0).
  
  
  CONCLUSIONS
  Integrating FP services into HIV care significantly increased the use of modern FP methods but no impact on pregnancy incidence. HIV programs need to consider integrating FP into their program structure.
authors.affiliation: United States Agency for International Development-Academic Model Providing Access to Healthcare Partnership, Eldoret, Kenya. salilkabon@yahoo.com
authors.forename: Rose J
authors.initials: RJ
authors.lastname: Kosgei
authors.forename: Kizito M
authors.initials: KM
authors.lastname: Lubano
authors.forename: Changyu
authors.initials: C
authors.lastname: Shen
authors.forename: Kara K
authors.initials: KK
authors.lastname: Wools-Kaloustian
authors.forename: Beverly S
authors.initials: BS
authors.lastname: Musick
authors.forename: Abraham M
authors.initials: AM
authors.lastname: Siika
authors.forename: Hillary
authors.initials: H
authors.lastname: Mabeya
authors.forename: E Jane
authors.initials: EJ
authors.lastname: Carter
authors.forename: Ann
authors.initials: A
authors.lastname: Mwangi
authors.forename: James
authors.initials: J
authors.lastname: Kiarie
mesh_terms: D000328:Adult; D015331:Cohort Studies; D017280:Condoms / Q000706:statistics & numerical data*; D003268:Contraception Behavior / Q000706:statistics & numerical data*; D003270:Contraceptive Agents / Q000008:administration & dosage; D005193:Family Planning Services / Q000379:methods / Q000458:organization & administration*; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control* / Q000628:therapy; D006801:Humans; D007630:Kenya / Q000453:epidemiology; D010865:Pilot Projects; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies
chemical_list: D003270:Contraceptive Agents