Tao Amy R, Onono Maricianah, Baum Sarah, Grossman Daniel, Steinfeld Rachel, Cohen Craig R, Bukusi Elizabeth A, Newmann Sara J
a Department of Obstetrics, Gynecology, and Reproductive Sciences , University of California , San Francisco , CA , USA.
AIDS Care. 2015;27(1):31-7. doi: 10.1080/09540121.2014.954982. Epub 2014 Oct 20.
Integration of family planning (FP) services into HIV care and increasing male partner involvement in FP are being explored as strategies to reduce unmet need for contraception. Providers' views can give valuable insight into current FP care. We evaluated the perspectives of HIV care providers working at HIV clinics in Nyanza Province, Kenya, on male partner involvement in FP. This qualitative study was part of a cluster-randomized controlled trial evaluating the impact of integrating FP into HIV services on contraceptive prevalence among HIV-positive patients in Nyanza Province, Kenya. Thirty individual interviews were conducted among health-care workers at 11 HIV care facilities in Nyanza Province, Kenya. Interviews were conducted from integrated and control sites one year after implementation of FP/HIV integration. Data were transcribed and analyzed using grounded theory methods and ATLAS-ti. Providers supported male partner inclusion when choosing FP and emphasized that decisions should be made collaboratively. Providers believed that men have traditionally played a prohibitive role in FP but identified several benefits to partner involvement in FP decision-making including: reducing relationship conflicts, improving FP knowledge and contraceptive continuation, and increasing partner cohesion. Providers suggested that integrated FP/HIV services facilitate male partner involvement in FP decision-making since HIV-positive men are already established patients in HIV clinics. Some providers stated that women had a right to choose and start FP alone if their partners did not agree with using FP. Integrated FP services may be a useful strategy to help increase male participation to reduce the unmet FP need in sub-Saharan Africa. It is important to determine effective ways to engage male partners in FP, without impinging upon women's autonomy and reproductive rights.
将计划生育（FP）服务纳入艾滋病护理，并提高男性伴侣对计划生育的参与度，正被作为减少未满足的避孕需求的策略进行探索。提供者的观点可以为当前的计划生育护理提供有价值的见解。我们评估了在肯尼亚尼扬扎省艾滋病诊所工作的艾滋病护理提供者对男性伴侣参与计划生育的看法。这项定性研究是一项整群随机对照试验的一部分，该试验评估了将计划生育纳入艾滋病服务对肯尼亚尼扬扎省艾滋病阳性患者避孕普及率的影响。在肯尼亚尼扬扎省的11个艾滋病护理机构对医护人员进行了30次个人访谈。在实施计划生育/艾滋病整合一年后，从综合站点和对照站点进行了访谈。数据采用扎根理论方法和ATLAS-ti进行转录和分析。提供者支持男性伴侣在选择计划生育时参与其中，并强调决策应共同做出。提供者认为，男性传统上在计划生育中起到了阻碍作用，但也指出伴侣参与计划生育决策有几个好处，包括：减少关系冲突、提高计划生育知识和避孕措施的持续使用、增强伴侣凝聚力。提供者建议，计划生育/艾滋病综合服务有助于男性伴侣参与计划生育决策，因为艾滋病阳性男性已经是艾滋病诊所的既定患者。一些提供者表示，如果女性的伴侣不同意使用计划生育措施，女性有权独自选择并开始使用。计划生育综合服务可能是一种有用的策略，有助于增加男性的参与度，以减少撒哈拉以南非洲未满足的计划生育需求。确定有效的方法让男性伴侣参与计划生育，同时不侵犯女性的自主权和生殖权利非常重要。
