Feasibility, Effectiveness, and Cost of Models of Integrating Counseling and Testing for HIV Within Family Planning Services in Kenya
Council researchers tested two models of integrating family planning and HIV counseling and testing (C&T) services in Kenya.
The Kenyan government is emphasizing knowledge of one’s own HIV status as a major strategy in its fight against HIV and AIDS. In support of that strategy, FRONTIERS worked with the Division of Reproductive Health of the Ministry of Health and the National AIDS Control Program to test two models of integrating family planning and HIV counseling and testing (C&T) services. In the “testing” model, family planning providers were trained to offer C&T services and post-test counseling during the same visit, while in the “referral” model, family planning clients wanting C&T services were referred to a specialized C&T facility.
Providers were trained to routinely use the Balanced Counseling Strategy Plus (BCS+) toolkit, which is an adaptation for high-HIV-prevalence settings of the Population Council’s BCS tool for improving the quality of family planning counseling. Integrating STI/HIV counseling and offering C&T within family planning services was feasible and acceptable to clients and providers. Overall quality of care improved significantly in both models, especially in the referral-model clinics. The increased quality may have been due to greater use of the BCS+ tool by providers at the referral clinics (75%) versus those at the testing clinics (41%). HIV C&T increased significantly during family planning consultations. The proportion of providers discussing C&T increased significantly between baseline and endline (from 39% to 88%). A significantly greater proportion of providers offered an HIV test following the intervention (from 1% at baseline to 39% for repeat clients and 48% for new clients).
Based on these findings, the MOH adopted and recommended expanding both models of the integration strategy nationwide. Training of provincial-level trainers in all eight provinces of Kenya began in September 2007 with support from FRONTIERS, the US Centers for Disease Control and Prevention, and USAID through its bilateral APHIA II partners. Over 150 providers have received training, which is ongoing.
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Duration: 7/2005 - 1/2008
Kenya Ministry of Health
National AIDS Control Program