title: A Novel Safer Conception Counseling Toolkit for the Prevention of HIV: A Mixed-Methods Evaluation in Kisumu, Kenya.
abstract: Safer conception strategies can prevent HIV transmission between HIV-discordant partners while allowing them to conceive. However, HIV care providers in sub-Saharan Africa report they are not trained in safer conception, and patients are not routinely offered safer conception services. This mixed-methods pilot study evaluated the impact, acceptability, and feasibility of a novel Safer Conception Counseling Toolkit among providers and patients in Kenya. We enrolled 20 HIV-positive women, 10 HIV-discordant couples, and 10 providers from HIV care and treatment clinics. Providers completed questionnaires before/after training, and then counseled HIV-affected patients. Change in patient knowledge was assessed before/after counseling. Qualitative interviews were conducted among providers and patients. The Toolkit was associated with large, significant increases in patient knowledge, and provider confidence, knowledge, and favorable attitudes toward safer conception counseling; 20% felt confident before versus 100% after training (p < 0.01).
authors.affiliation: Department of Epidemiology and Biostatistics and the Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco.
authors.forename: Joelle
authors.initials: J
authors.lastname: Brown
authors.affiliation: Kenya Medical Research Institute (KEMRI), Nairobi, Kenya.
authors.forename: Betty
authors.initials: B
authors.lastname: Njoroge
authors.affiliation: KEMRI - FACES, Kisumu, Kenya.
authors.forename: Eliud
authors.initials: E
authors.lastname: Akama
authors.affiliation: Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora, Colorado.
authors.forename: Brooke
authors.initials: B
authors.lastname: Breitnauer
authors.affiliation: Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
authors.forename: Anna
authors.initials: A
authors.lastname: Leddy
authors.affiliation: School of Nursing and the Center for Sexuality and Health Disparities, Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, Michigan.
authors.forename: Lynae
authors.initials: L
authors.lastname: Darbes
authors.affiliation: KEMRI - FACES, Kisumu, Kenya.
authors.forename: Richard
authors.initials: R
authors.lastname: Omondi
authors.affiliation: Department of Obstetrics and Gynecology, University of Michigan Medical School, and the Department of Health Education and Health Behavior, School of Public Health, University of Michigan.
authors.forename: Okeoma
authors.initials: O
authors.lastname: Mmeje
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003376:Counseling / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D015658:HIV Infections / Q000517:prevention & control*; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D007407:Interviews as Topic; D007630:Kenya; D008297:Male; D010342:Patient Acceptance of Health Care; D010865:Pilot Projects; D036301:Qualitative Research; D012747:Sexual Partners / Q000523:psychology