Decreasing Unintended Pregnancy and Vertical Transmission of HIV Through Family Planning: Where Do Men Fit In?

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Family planning is an effective way of decreasing vertical transmission of HIV and maternal and neonatal morbidity and mortality associated with untreated HIV and pregnancy. Clinicians and researchers world-wide are recognizing the importance of integrating family planning and HIV care for these reasons. However, there are many recognized obstacles to integrating these two types of care and funding streams remain separate. Many of the barriers to integration, such as method availability and adequate training, staffing, and space, are surmountable with sufficient financial and logistical support. However, the impact that socio-cultural norms, and culturally influenced gender-based power dynamics, have on contraceptive choice in Western Africa, an area with high HIV prevalence and a history of polygamy, remains elusive. Providers and clients alike have reported the importance of including men in contraceptive-decision making in order to decrease unintended pregnancies among HIV-infected individuals in Kenya. The purpose of this one-year proposed study is to perform qualitative, hypothesis-generating research to better understand the current role men play in contraceptive decision-making in western Kenya. Thirty in-depth interviews and three focus groups with HIV + and HIV- men living in the highest HIV prevalent areas of rural Nyanza Province in western Kenya will be conducted. Data from this study will be analyzed according to grounded theory for theme content and used to inform the creation of a community-based intervention geared towards educating men about family planning and HIV and incorporating men into the contraceptive decision-making process.