Presentation at the Global Maternal Newborn Health Conference, October 19, 2015
Background: PPTCT programs in India mainly focus on prong 3 i.e. providing antiretroviral prophylaxis for prevention of HIV transmission from mother to child. However, studies reveal that condoms are the only contraceptives promoted in HIV programs mainly for infection control. Thus many HIV positive women face unwanted pregnancies and become vulnerable to the risk of maternal and neonatal morbidities/mortalities.
Methodology: Situation analysis comprising of health facility survey, health provider’s interviews and client needs assessment was undertaken at secondary and tertiary public hospitals in Mumbai (India) to assess the level of linkages that exist between HIV and Family Planning programs. Evidence based strategies were developed to strengthen linkages which focused on training providers, provision of IEC material for advocacy and counselling, improving referral to family planning clinics from PPTCT/ICTC using coloured referral slip and strengthening the documentation of data for monitoring and evaluation. The same was tested at experimental and control hospital sites among 300 women infected with HIV.
Results: There was an overall improvement in the knowledge and attitude of service providers to advocate other contraceptives along with condoms. Cross talk between the two departments improved and a conducive stigma free environment was generated which improved access to contraceptive services by PLHIV. Compared to the control group, the acceptance and use of dual methods increased three times and consistent condom use improved significantly. Interventions helped reduce the cumulative risk of unintended pregnancies by 8.5% in experimental group compared to the control group.
Conclusions: HIV and Family Planning linkages are feasible. Program directives for HIV Family planning linked services need to be drafted and issued along with country specific standard guidelines for provision of family planning among PLHIV. A strong advocacy on use of dual methods for dual protection is necessary to encourage couples make informed choices to plan pregnancies.