Factors influencing the utilization of family planning services among HIV infected women in a Kenyan health facility

Background: Women’s knowledge and access to reproductive health services improves their ability to safely achieve their required fertility and reduces maternal and infant morbidity and mortality. We aimed to determine the utilization of family planning (FP) among HIV Infected women visiting the HIV clinic. Methods: A cross-sectional mixed quantitative and qualitative study among HIV positive females in Nairobi, Kenya was conducted. Consenting women completed a questionnaire that assessed the utilization of FP services. Descriptive and inferential analysis was carried out on quantitative data to determine significant associations with FP utilization. Qualitative data were analyzed after coding for significant clauses and transcribing to determine themes arising. Results: We enrolled a total of 387 patients, mean age (IQ range) 40 years (36-44). The contraceptive prevalence was 53% with an unmet need of family planning of 38.5%. Patients were more likely to use family planning if they were married, if condoms were offered at the clinic, if they discussed contraception with the clinic staff and their partners. They were less likely to use FP if they had expressed fertility desire. Widows were less likely to use any form of FP than married couples despite having sexual partners. The main themes on the barriers of utilization of family planning services included lack of knowledge, pill burden, and adverse reactions to hormonal FP. Conclusions: The unmet need of family planning is high, and heightened measures need to be taken to improve the utilization of the service. Particular groups such as sexually active widows and single women should be targeted for these interventions.