Grant-Maidment Tallulah, Kranzer Katharina, Ferrand Rashida A
London School of Hygiene and Tropical Medicine, London, United Kingdom.
Biomedical Research and Training Institute, Harare, Zimbabwe.
Front Glob Womens Health. 2022 Feb 24;3:837358. doi: 10.3389/fgwh.2022.837358. eCollection 2022.
There is substantial unmet need for family planning (FP) among women living with HIV (WLHIV), leading to unintended pregnancies and may contribute indirectly to increasing the risk of transmission of HIV. This review aims to determine whether integration of FP into HIV testing and care results in increased use of contraception, a reduction in unmet need for FP, improved use of safer conception methods and a reduction in unintended pregnancies in low and middle-income countries. A systematic review was undertaken incorporating studies from PubMed, EMBASE, CINAHL, Web of Science and Global Health, the International AIDS Society Abstract Archive, the World STI & HIV Congress Abstract Archive and the Conference on Retroviruses and Opportunistic Infections Abstract Archive published between 2016 and 2021, updating previous systematic reviews. After screening, 13 studies were included, 11 conducted in sub-Saharan Africa and 2 in India. The primary outcome of the review was contraceptive uptake and secondary outcomes included unmet need for FP, safer conception and unintended pregnancy. Integrated FP-HIV facilities were found to increase dual contraceptive use by at least 8% in five studies and modern contraceptive use by at least 8% in four studies. Findings from two studies suggested integration decreased the unmet need for contraception. Limited data prevented a conclusion from being drawn regarding whether integration increases safer conception. There was no evidence of integration reducing unintended pregnancies. The median quality score of studies was 3/9. Overall, integrated facilities have the potential of improving reproductive health of women accessing HIV services in LMICs. FP may be enhanced by including a safer conception component for WLHIV.
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021251008, identifier: CRD42021251008.
感染艾滋病毒的女性（WLHIV）对计划生育（FP）有着大量未满足的需求，这导致意外怀孕，并可能间接增加艾滋病毒传播风险。本综述旨在确定在低收入和中等收入国家，将计划生育纳入艾滋病毒检测和护理是否会导致避孕措施使用增加、未满足的计划生育需求减少、更安全受孕方法的使用得到改善以及意外怀孕减少。进行了一项系统综述，纳入了2016年至2021年间发表于PubMed、EMBASE、CINAHL、科学网和全球卫生数据库、国际艾滋病学会摘要存档、世界性传播感染与艾滋病毒大会摘要存档以及逆转录病毒与机会性感染大会摘要存档的研究，对之前的系统综述进行了更新。筛选后，纳入了13项研究，其中11项在撒哈拉以南非洲进行，2项在印度进行。综述的主要结果是避孕措施的采用情况，次要结果包括未满足的计划生育需求、更安全受孕以及意外怀孕。在五项研究中发现，综合的计划生育 - 艾滋病毒服务设施使双重避孕措施的使用至少增加了8%，在四项研究中使现代避孕措施的使用至少增加了8%。两项研究的结果表明，整合减少了未满足的避孕需求。由于数据有限，无法得出整合是否增加更安全受孕的结论。没有证据表明整合能减少意外怀孕。研究的质量得分中位数为3/9。总体而言，综合设施有潜力改善低收入和中等收入国家接受艾滋病毒服务的女性的生殖健康。对于感染艾滋病毒的女性，纳入更安全受孕的内容可能会加强计划生育。
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021251008，标识符：CRD42021251008 。
