Impact of integrated family planning and HIV care services on contraceptive use and pregnancy outcomes: a retrospective cohort study.
Impact of integrated family planning and HIV care services on contraceptive use and pregnancy outcomes: a retrospective cohort study.
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DOI：
10.1097/qai.0b013e318237ca80
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发表时间：
2011-12-15
期刊：
影响因子：
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通讯作者：
Kiarie J
中科院分区：
文献类型：
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作者：
Kosgei RJ;Lubano KM;Shen C;Wools-Kaloustian KK;Musick BS;Siika AM;Mabeya H;Carter EJ;Mwangi A;Kiarie J
确定常规护理（RC）和综合计划生育（IFP）以及艾滋病毒护理服务对计划生育（FP）接受率和妊娠结局的影响。在2005年10月10日至2009年2月28日期间进行的回顾性队列研究。美国国际开发署-肯尼亚西部提供医疗保健机会的学术模式。感染艾滋病毒的成年妇女的记录。将计划生育纳入其中一个护理团队。FP方法和妊娠的发生率。4 031名妇女（1 453名IFP; 2 578名RC）符合条件。在IFP组中，避孕套使用率增加12.9%（P < 0.001）[95%可信区间（CI）：13.2%~ 20.2%]（P < 0.001）。（95% CI：9.4%至16.4%），包括避孕套在内的计划生育使用率降低3.8%使用FP（不包括避孕套）的发生率增加0.1%（P < 0.001）（95% CI：1.9%至5.6%），妊娠发生率增加0.1%（P = 0.9）（95% CI：-1.9%至2.1%）。每100人-年IFP和RC发生率的归因危险度为16.4（95% CI：11.9 - 21.0），包括避孕套在内的新计划生育使用率为13.5（95% CI：8.7至18.3），不包括避孕套的新计划生育使用率为-3.0（95% CI：-4.6至-1.4），新怀孕病例为1.2（95% CI：-0.6至3.0）。将计划生育服务纳入艾滋病毒护理显着增加了现代计划生育方法的使用，但对妊娠发生率没有影响。艾滋病毒方案需要考虑将计划生育纳入其方案结构。
To determine the impact of routine care (RC) and integrated family planning (IFP) and HIV care service on family planning (FP) uptake and pregnancy outcomes. Retrospective cohort study conducted between October 10, 2005, and February 28, 2009. United States Agency for International Development—Academic Model Providing Access To Healthcare (USAID-AMPATH) in western Kenya. Records of adult HIV-infected women. Integration of FP into one of the care teams. Incidence of FP methods and pregnancy. Four thousand thirty-one women (1453 IFP; 2578 RC) were eligible. Among the IFP group, there was a 16.7% increase (P < 0.001) [95% confidence interval (CI): 13.2% to 20.2%] in incidence of condom use, 12.9% increase (P < 0.001) (95% CI: 9.4% to 16.4%) in incidence of FP use including condoms, 3.8% reduction (P < 0.001) (95% CI: 1.9% to 5.6%) in incidence of FP use excluding condoms, and 0.1% increase (P = 0.9) (95% CI: −1.9% to 2.1%) in incidence of pregnancies. The attributable risk of the incidence rate per 100 person-years of IFP and RC for new condom use was 16.4 (95% CI: 11.9 to 21.0), new FP use including condoms was 13.5 (95% CI: 8.7 to 18.3), new FP use excluding condoms was −3.0 (95% CI: −4.6 to −1.4) and new cases of pregnancies was 1.2 (95% CI: −0.6 to 3.0). Integrating FP services into HIV care significantly increased the use of modern FP methods but no impact on pregnancy incidence. HIV programs need to consider integrating FP into their program structure.