Preventing unintended pregnancy among HIV-positive women is an effective approach to reducing pediatric HIV infection and vital to meeting HIV-positive women’s sexual and reproductive health needs (WHO 2002, 2004; UNFPA 2004). Although contraceptive services for HIV-positive women is one of the four cornerstones of a comprehensive program for prevention of mother-to-child transmission of HIV (PMTCT), a review of PMTCT programs found that implementers have not prioritized family planning (Rutenberg and
Baek 2004). While there is increasing awareness about the importance of family planning and HIV integration, data about family planning from PMTCT clients are lacking.
The Horizons Program, in collaboration with International Medical Corps (IMC) and Steadman Research Services International (SRSI), is conducting an operations research study testing several community-based strategies to reduce mother-to-child transmission
of HIV in a densely settled urban slum area in Nairobi, Kenya. The strategies being piloted by IMC include moving PMTCT services closer to the population via a mobile clinic, and increasing psychosocial support for HIV-positive women through the use of traditional birth attendants and peer counselors. Peer counselors are HIV-positive women who have already received PMTCT services. The effectiveness of each of these strategies on women’s utilization
of key PMTCT services, including family planning, will be measured by comparing
baseline to follow-up data.
This research update presents key findings about family planning at PMTCT sites, including the interaction between providers and clients as well as HIV-positive women’s fertility
desires and demand for contraceptives, from the baseline cross-sectional survey and qualitative interviews with postpartum women.