aLondon School of Hygiene & Tropical Medicine, London, UK bPopulation Council, Nairobi, Kenya cCentral Statistics Office, Mbabane, Swaziland.
AIDS. 2013 Oct;27 Suppl 1:S55-63. doi: 10.1097/QAD.0000000000000046.
Little is known about the need and demand for integrated reproductive health and HIV services at the population level.
Descriptive data analysis of household surveys collected by the Integra Initiative.
Household surveys were conducted among 18-49-year-olds in Kenya (N = 1752) and Swaziland (N = 779) in 2009. Data on fertility intentions, contraceptive use, sexual behaviours and HIV testing were used to determine unmet needs. Demand for integrated services was defined as wanting reproductive health services with HIV/sexually transmitted infection (STI) services within one visit.
At the population level, family planning needs (90%) were higher than HIV/STI prevention needs: 53% (women) and 75% (men). Fewer had unmet family planning needs through non-use of contraceptives: 17% (women) and 27% (men); versus unmet HIV/STI prevention needs through inconsistent condom use: 48 and 26% of women; 51 and 32% of men in Kenya and Swaziland, respectively. Dual need was higher for men: 64% (Kenya) and 73% (Swaziland) versus women (48%) with more unmet in Kenya (43%) compared to Swaziland (25%). Missed opportunities for integrated service provision were high among women: 49 and 57% with unmet family planning needs; and 55 and 32% with unmet HIV/STI prevention needs in Kenya and Swaziland, respectively, used services, but did not receive the needed service. Most men with unmet needs were non-service users. Approximately a quarter of women wanted and received integrated reproductive health-HIV/STI services in both countries.
Demand creation at the community level and provider-initiated integrated service provision are needed, using different strategies for men and women, to address substantial family planning and HIV/STI prevention needs.
对于人群层面的综合性生殖健康和艾滋病毒服务的需求和需求，人们知之甚少。
综合倡议收集的家庭调查的描述性数据分析。
2009 年，在肯尼亚（N=1752）和斯威士兰（N=779）对 18-49 岁的人进行了家庭调查。利用生育意愿、避孕使用、性行为和艾滋病毒检测数据，确定未满足的需求。对综合服务的需求定义为希望在一次就诊中获得生殖健康服务和艾滋病毒/性传播感染（STI）服务。
在人群层面，计划生育需求（90%）高于艾滋病毒/性传播感染预防需求：53%（女性）和 75%（男性）。未满足的计划生育需求较少，原因是未使用避孕药具：17%（女性）和 27%（男性）；而艾滋病毒/性传播感染预防需求未得到满足的原因是避孕套使用不一致：肯尼亚和斯威士兰的女性分别为 48%和 26%，男性分别为 51%和 32%。男性的双重需求更高：肯尼亚为 64%（肯尼亚）和 73%（斯威士兰），斯威士兰为 48%（女性），肯尼亚的未满足需求更高（43%），而斯威士兰的未满足需求（25%）。在肯尼亚和斯威士兰，未满足计划生育需求的女性中，有 49%和 57%的人错过了提供综合服务的机会；未满足艾滋病毒/性传播感染预防需求的女性分别为 55%和 32%，分别使用了服务，但未获得所需的服务。大多数未满足需求的男性都不是服务使用者。大约四分之一的妇女在两国都希望并接受了综合生殖健康艾滋病毒/性传播感染服务。
需要在社区层面创造需求，并由提供者发起综合服务提供，针对男性和女性采用不同的策略，以满足大量的计划生育和艾滋病毒/性传播感染预防需求。
