title: Fertility intentions and interest in integrated family planning services among women living with HIV in Nyanza Province, Kenya: a qualitative study.
abstract: Despite increasing efforts to address the reproductive health needs of people living with HIV, a high unmet need for contraception exists among HIV+ women in sub-Saharan Africa. This study explores the fertility intentions and family planning (FP) preferences of Kenyan women accessing HIV treatment. We conducted 30 semistructured interviews and qualitatively analyzed the data with a grounded theory approach. Fears of premature death, financial hardship, and perinatal HIV transmission emerged as reasons for participants' desire to delay/cease childbearing. Participants strongly identified FP needs, yet two-thirds were using male condoms alone or no modern method of contraception. Women preferred the HIV clinic as the site of FP access for reasons of convenience, provider expertise, and a sense of belonging, though some had privacy concerns. Our findings support the acceptability of integrated FP and HIV services. Efforts to empower women living with HIV to prevent unintended pregnancies must expand access to contraceptive methods, provide confidential services, and take into account women's varied reproductive intentions.
authors: Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, CA 94612, USA.
authors: Elizabeth K
authors: EK
authors: Harrington
authors: Sara J
authors: SJ
authors: Newmann
authors: Maricianah
authors: M
authors: Onono
authors: Katie D
authors: KD
authors: Schwartz
authors: Elizabeth A
authors: EA
authors: Bukusi
authors: Craig R
authors: CR
authors: Cohen
authors: Daniel
authors: D
authors: Grossman
mesh_terms: D000293:Adolescent; D000328:Adult; D019033:Delivery of Health Care, Integrated; D005193:Family Planning Services; D005260:Female; D005298:Fertility; D015658:HIV Infections / Q000523:psychology*; D007722:Health Knowledge, Attitudes, Practice; D006301:Health Services Needs and Demand; D006801:Humans; D033182:Intention; D007630:Kenya; D008875:Middle Aged; D036301:Qualitative Research; D011795:Surveys and Questionnaires; D055815:Young Adult