Family Planning / HIV Integration
Although it makes sense for programs to try to combine FP and HIV/AIDS prevention services, little is known about how these two issues relate to one another in the minds of clients or how communication can be used effectively to guide clients through the complex and inter-related set of considerations that fertility management and HIV/AIDS prevention entail.
During Year 3 of HCP, an in-depth study was conducted within selected communities in Zambia to understand the complex social, cultural, and individual decision-making dynamics that interact to affect a woman’s (or couple’s) decision to practice family planning in the context of HIV. Drawing on innovative qualitative methodologies, this research provided a rare opportunity to better understand how integration is filtered through the community lens, what aspects of it are working, and what needs to be strengthened.
The Year 3 results include a set of in-depth analytical reports and research protocols that can be used in settings beyond those for which they were developed to support program design. Development of the protocol and implementation of the field work was done in close collaboration with local partners to expand Southern capacity for this type of analysis. HCP also closely collaborated with the POLICY Project’s work to examine integration dynamics.
During Year 4, the results of an in-depth study were finalized within selected communities in Zambia to understand the complex social, cultural, and individual decision-making dynamics that interact to affect a woman’s (or couple’s) decision to practice FP in the context of HIV. This research provided a rare opportunity to better understand how integration is filtered through the community lens, what aspects of it are working, and what needs to be strengthened.
Preliminary findings are:
- Men are more likely to cite economic difficulties and women to cite the consequences of the epidemic as the reasons that couples in their communities are choosing to have smaller families than in the recent past.
- Although many study participants had heard of PMTCT, most did not think it could really reduce mother-to-child transmission, which is widely believed to occur at a rate of 100%. Almost all respondents from the community, regardless of status, argued that PLHAs should avoid pregnancy. Among the key informants who were clinicians, however, there was an understanding that PLHAs should have the right to make their own fertility decisions. A few participants noted that the reason a PLHA should not have more children is that he or she would put his/her sexual partner at risk, though the reason most frequently given was that the child would die prematurely or that the child would be orphaned.
- Study participants would welcome more information about FP. The findings demonstrated that there is a real need to: discuss FP in a comprehensive way that addresses misconceptions; tackle stigma, which was very much in the forefront of the discussions; and pursue gender programming that empowers women to bring issues up without retaliation.
- Study participants are eager to learn more about HIV transmission and prevention, PMTCT and ART.
Note about materials: Some of the materials and resources listed on each page are available in their full form, others are represented by image or citation only. For more information and resources, go to www.jhuccp.org