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

Abstract #65849

Susan M. Grantham, MPP¹, Michele N. Clark, MPH¹, Myriam Hernandez-Jennings, MA¹, Carolyn S. Bill, BA¹, Eugenie H. Coakley, MA, MPH¹, Alex M. Ely, BA¹, and Suzanne C. Theroux, MPH². (1) Health Services Division, JSI Research & Training Institute, Inc., 44 Farnsworth Street, Boston, MA 02210, (2) Office of Population Affairs/Office of Family Planning, Region I, JFK Federal Building, Room 2126, Boston, MA 02203

Findings from this DHHS/OPA/OFP-funded needs assessment highlight the challenges of integrating HIV risk assessment, prevention education, and counseling and testing (C&T) into New England Title X family planning clinics (n=213). Counselors and clinicians completed a provider survey (71% response). A survey of clinic managers (60% response) and site visits gathered organization-level information. Data were analyzed to determine HIV integration models; prevention, counseling and testing activities; attitudes and comfort; barriers to integration; and training needs. While most clinics surveyed provided STD screening and HIV prevention education (97%), HIV-related services including mental health, substance abuse, domestic violence, and prevention case management services were referred to off-site in 72-100% of clinics. Staff knowledge of community referral sources, particularly for substance abuse and HIV linkage services, was low. Though many clinics offered anonymous (53%) and confidential (72%) C&T, test cost, minimal training, and provider discomfort pose barriers. Various models of C&T/family planning were observed. Though nearly all clinics reported having a formal HIV risk assessment, only 31% of clinics assessed risk “at all visits.” Many tools (25% or more) excluded topics about coercive sexual experiences, oral sex, anal sex, same sex activity, and partners’ drug and sex behaviors. Providers also felt least comfortable addressing these areas. Organizational structure and funding must be considered when integrating HIV prevention and family planning. Establishing referral relationships can enhance quality of care for clients. Developing minimum standards for HIV risk assessment topics and protocol, along with counseling skills training, is likely to enhance assessment, education and referral activities.

Learning Objectives:

• Understand the importance and opportunity for HIV prevention integration family planning clinic settings.
• Identify HIV assessment, prevention education and counseling testing activities in New England Title X-funded family planning clinics.
• Identify organizational or systemic barriers to integrating HIV into family planning clinic settings.
• Consider comprehensive, systemic strategies for addressing HIV prevention integration.

Keywords: Family Planning, HIV/AIDS

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.