The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #62617

Robert A. Miller, DrPH¹, Andrew A. Fisher, ScD², Lewis Ndhlovu, PhD³, Catherine Searle³, Ester Snyman⁴, and Jeffrey Spieler⁵. (1) Senior Associate, International Programs Division, Population Council, 1 Dag Hamarskjold Plaza, New York, NY 10017, 212-339-0645, rmiller@popcouncil.org, (2) Horizons Program, Population Council, 4301 Connecticut Ave, NW, Suite 280, Washington, DC 20008, (3) International Programs/Horizons Program, Population Council, P.O. Box 411744, Craighall 2024, Johannesburg, South Africa, (4) Maternal, Child and Women's Health, KwaZulu Natal Department of Health, P Bag X54316, Durban 4000, South Africa, (5) GH/PRH/RTU, U.S. Agency for International Development, Ronald Reagan Building, 1300 Pennsylvania Avenue, NW, Washington, DC 20523-3601

The KwaZuluNatal Province of South Africa has numerous and pressing reproductive health problems including an HIV prevalence rate of about 36% among antenatal clients. Yet condom use in family planning (FP) is relatively low and there is evidence of low awareness and low practice of dual protection (DP). In response, the Sub-Directorate of Maternal, Child, and Women’s Health has attempted to integrate the promotion of condom use and DP into FP (and other services) but is not aware of actual provider practice at the facility level. In part to determine this, the Sub-Directorate in collaboration with the Population Council, carried out an HIV/AIDS-oriented Situation Analysis Study in 2002. Data from the observation of services provided to 89 new family planning clients in 58 clinics indicate that 73% of FP clients were encouraged to use condoms for STI/HIV protection and 55% for pregnancy protection – 45% received encouragement to use condoms for both STI/HIV and pregnancy prevention. No provider was observed to say anything negative about male condoms; only two negative comments about female condoms were observed. Less than a third of clients (28%) received information on how to use condoms. Twenty percent of FP clients actually received condoms. Client characteristics are explored as predictors of who gets DP counseling. The data suggest that the majority of FP clients receive encouragement to practice DP, but not to use condoms alone for DP, and do not receive the more complete information and supplies that would prepare them more fully to actually use condoms.

Learning Objectives:

• Participants will be able to describe the extent and with whom providers promote dual protection during FP counseling in KZN Province;
• Participants will be able to draw policy and program implications for strengthening dual protection in this high HIV prevalence environment.

Presenting author's disclosure statement:
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.