HIV Infections Clinical Trial
Official title:
Cluster Randomized Trial of Integration of Family Planning Services Into HIV Care and Treatment in Suba, Kisumu East, Rongo and Migori Districts of Nyanza Province
This is a cluster randomized trial comparing the integration of family planning services into HIV care and treatment programs versus the standard referral for family planning services outside of HIV care and treatment programs within Suba, Kisumu East, Rongo and Migori districts in Nyanza province.
The study will have three parts. During the first part (3 months), baseline data on
contraceptive prevalence and unintended pregnancy will be collected at 18 PSCs that are
supported by the FACES program in Suba, Kisumu East, Nyatike, Rongo and Migori Districts.
Also during this first part, information about knowledge, attitudes and practices related to
family planning will be obtained from patients and from clinicians at the sites. During the
second part (3 months), an intervention consisting of integrating family planning services
will be designed and implemented at twelve of the 18 FACES-supported PSCs. We aim to utilize
a 2:1 integration:control model, with delayed integration so as to gradually expand the
integration of FP and HIV services throughout the 18 sites, while maintaining the ability to
test hypotheses on the effects of integration on health outcomes. After collecting the
baseline data, we plan to stratify the clinics into two categories based on the overall
patient volume and differences in the structure of family planning provision, i.e., whether
or not there is a specific MCH division providing family planning at the site or not.
Randomization of sites will then occur among clinics in each of these strata, with a ratio
of two intervention sites (integrated model) to one control site (family planning provided
in the standard manner at the site). During the third and last part (12 months), data on
prevalence more effective contraception and unintended pregnancy will be collected from each
of the 18 sites. At the end of part three, information about knowledge, attitudes and
practices related to family planning again will be obtained from patients and from
clinicians at the sites. In addition, we will administer questionnaires assessing the
acceptability of family planning services to patients, and in addition clinic staff will be
answer a questionnaire assessing the feasibility of providing integrated family planning
services. After 12 months of data collection, the 6 control sites were integrated and data
were collected for an additional 11 months from all 18 sites to assess the sustainability of
the intervention under the Ministry of Health.
The study population will primarily consist of HIV-positive men and non-pregnant,
HIV-positive women of reproductive age who obtain care at the FACES-supported PSCs in Suba,
Kisumu East, Rongo and Migori Districts in Nyanza Province, Kenya. In addition, study
subjects will also include clinic staff at the FACES centers included in the study.
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Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Health Services Research
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