TY - JOUR
T1 - Integration of Family Planning Services into HIV Care and Treatment Services
T2 - A Systematic Review
AU - Haberlen, Sabina A.
AU - Narasimhan, Manjulaa
AU - Beres, Laura K.
AU - Kennedy, Caitlin E.
N1 - Funding Information:
We thank Namratha Rao for assistance with citation screening. We also thank the authors of the previous systematic reviews and Hacsi Horvath for their collaborations on previous work that informed this review. This review was funded by the World Health Organization, Department of Reproductive Health and Research.
Publisher Copyright:
© 2017 The Population Council, Inc.
PY - 2017/6
Y1 - 2017/6
N2 - Evidence on the feasibility, effectiveness, and cost-effectiveness of integrating family planning (FP) and HIV services has grown significantly since the 2004 Glion Call to Action. This systematic review adds to the knowledge base by characterizing the range of models used to integrate FP into HIV care and treatment, and synthesizing the evidence on integration outcomes among women living with HIV. Fourteen studies met our inclusion criteria, eight of which were published after the last systematic review on the topic in 2013. Overall, integration was associated with higher modern method contraceptive prevalence and knowledge, although there was insufficient evidence to evaluate its effects on unintended pregnancy or achieving safe and healthy pregnancy. Evidence for change in unmet need for FP was limited, although two of the three evaluations that measured unmet need suggested possible improvements associated with integrated services. However, improving access to FP services through integration was not always sufficient to increase the use of more effective (noncondom) modern methods among women who wanted to prevent pregnancy. Integration efforts, particularly in contexts where contraceptive use is low, must address community-wide and HIV-specific barriers to using effective FP methods alongside improving access to information, commodities, and services within routine HIV care.
AB - Evidence on the feasibility, effectiveness, and cost-effectiveness of integrating family planning (FP) and HIV services has grown significantly since the 2004 Glion Call to Action. This systematic review adds to the knowledge base by characterizing the range of models used to integrate FP into HIV care and treatment, and synthesizing the evidence on integration outcomes among women living with HIV. Fourteen studies met our inclusion criteria, eight of which were published after the last systematic review on the topic in 2013. Overall, integration was associated with higher modern method contraceptive prevalence and knowledge, although there was insufficient evidence to evaluate its effects on unintended pregnancy or achieving safe and healthy pregnancy. Evidence for change in unmet need for FP was limited, although two of the three evaluations that measured unmet need suggested possible improvements associated with integrated services. However, improving access to FP services through integration was not always sufficient to increase the use of more effective (noncondom) modern methods among women who wanted to prevent pregnancy. Integration efforts, particularly in contexts where contraceptive use is low, must address community-wide and HIV-specific barriers to using effective FP methods alongside improving access to information, commodities, and services within routine HIV care.
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U2 - 10.1111/sifp.12018
DO - 10.1111/sifp.12018
M3 - Article
C2 - 28337766
AN - SCOPUS:85020079888
SN - 0039-3665
VL - 48
SP - 153
EP - 177
JO - Studies in Familiy Planning
JF - Studies in Familiy Planning
IS - 2
ER -