Abstract:
Objective—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.
Design—Retrospective cohort study conducted between October 10, 2005, and February 28,
2009.
Setting—United States Agency for International Development—Academic Model Providing
Access To Healthcare (USAID-AMPATH) in western Kenya.
Subjects—Records of adult HIV-infected women.
Intervention—Integration of FP into one of the care teams.
Primary Outcomes Measures—Incidence of FP methods and pregnancy.
Results—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
