Integrating¬†voluntary¬†HIV¬†counselling¬†and¬†testing¬†(VCT) with¬†family¬†planning¬†and other reproductive healthservices¬†may be one effective strategy for expanding VCT¬†service¬†delivery in resource poor settings. Using 30,257 VCT¬†client¬†records with linked facility characteristics from Ethiopian non-governmental, non-profit, reproductive health clinics, we constructed multi-level logistic regression models to examine associations between¬†HIV¬†and¬†family¬†planning¬†service¬†integration¬†modality and three outcomes: VCT¬†client¬†composition,client-initiated¬†HIV¬†testing¬†and¬†client¬†HIV¬†status. Associations between facility¬†HIV¬†and¬†family¬†planningintegration¬†level and the likelihood of VCT¬†clients¬†being atypical¬†family¬†planning¬†client-types, versus older (at least 25 years old), ever-married women were assessed. Relative to facilities co-locating¬†services¬†in the same compound, those offering¬†family¬†planning¬†and¬†HIV¬†services¬†in the same rooms were 2‚Äì13 times more likely to serve atypical¬†family¬†planning¬†client-types than older, ever-married women. Facilities where counsellors jointly offered¬†HIV¬†and¬†family¬†planning¬†services¬†and served many repeat¬†family¬†planning¬†clientswere significantly less likely to serve single¬†clients¬†relative to older, married women. Younger, single men and older, married women were most likely to self-initiate¬†HIV¬†testing¬†(78.2 and 80.6% respectively), while the highest¬†HIV¬†prevalence was seen among older, married men and women (20.5 and 34.2% respectively). Compared with facilities offering co-located¬†services, those¬†integrating¬†services¬†at room- and counsellor-levels were 1.9‚Äì7.2 times more likely to serve¬†clients¬†initiating¬†HIV¬†testing. These health facilities attract both standard material and child health (MCH)¬†clients, who are at high risk for¬†HIV¬†in these data, and young, single people to VCT. This analysis suggests that¬†client¬†types may be differentially attracted to these facilities depending on¬†service¬†integration¬†modality and other facility-level characteristics.
GI Publications & Resources
HIV and family planning service integration and voluntary HIV counseling and testing client composition in Ethiopia
Publication Year: 2008
Link to File: https://www.tandfonline.com/doi/abs/10.1080/09540120701449112#.U78Jhq1dVm0