Introduction. With an increase in HIV prevalence from 1.2% in 1992 to nearly 6% by 1999 among antenatal women in Nigeria, integration of HIV/STD services within family planning (FP) is critical. A dual protection (DP)counselling intervention was initiated in six FP clinics in Ibadan to increase clients' perceptions of their dual HIV/STD and pregnancy risks, identify facilitators and barriers to DP, and increase DP practice.
Methods. Observations of client-provider interactions and client exit interviews conducted at baseline and nine months later, and clinic service statistics were used to assess changes among providers and clients.
Results. Male condom uptake increased from 2% to 4% between 1999 and 2000. Female condom uptake cannot yet be determined since free female condom distribution has only recently ended. Nearly half of the clients indicated that dual method use was as acceptable as single method use. Provider discussion of HIV and the disease protection benefits of contraceptive methods, and exploration of partners' sexual behavior increased significantly during counselling with new clients. Among continuing clients, these increases were lower, however. The proportion of clients who had heard about DP, were aware that condoms protect against HIV, asked a nurse for male condoms, and reported intentions to use condoms increased among all clients.
Conclusion. Although DP counselling has not been provided to all clients, providers have made a significant value shift in how they perform their clinic roles. Total integration of DP within FP requires a year or two before being fully implemented.
Learning Objectives: 1. Describe an innovative reproductive health operations research program that integrates HIV and STD services within family planning. 2. Discuss the importance of dual protection in reproductive health service delivery.
Keywords: Reproductive Health Research, International Reproductive Health
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Association for Reproductive & Family Health
Adeoyo State Hospital
Jericho Nursing Home
Oni Memorial Hospital
Planned Parenthood Federation of Nigeria
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.