R Revathy, Himanshu Chaurasia, Siddesh Shetty, Beena Joshi
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HIV care with no/minimal focus on FP was considered a comparator. Quality was assessed using design-appropriate tools. Descriptive analysis was presented in tables. Uptake of dual methods, unmet FP needs and unintended pregnancies were included in the meta-analysis to estimate pooled odds ratio (OR) with random effect model, P and I2 values.</p><p><strong>Results: </strong>The search yielded 2112 results. After excluding duplicates and unfit articles, 17 were found eligible for review and nine for meta-analysis. The pooled OR for uptake of dual contraception was 1.69 (1.14, 2.5) ( P =0.008; I2 =90%), for unmet FP needs was 0.58 (0487, 0.69) ( P <0.00001; I2 =0%) and for unintended pregnancies was 0.6 (0.32, 1.1) ( P =0.1, I2 =38%).</p><p><strong>Interpretation conclusions: </strong>The results of this meta-analysis suggest that health facility-based interventions to integrate HIV and FP services do result in improved uptake of dual methods and reduce unmet need for contraception along with a protective trend on incidence of unintended pregnancies. Such facility-based integration would ensure universal access to effective contraception and facilitate in achieving Sustainable Development Goals that aim at ending epidemics like HIV.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":null,"pages":null},"PeriodicalIF":2.7000,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10878490/pdf/","citationCount":"0","resultStr":"{\"title\":\"Health facility-based interventions and the uptake of contraception among people living with HIV: A systematic review & meta-analysis.\",\"authors\":\"R Revathy, Himanshu Chaurasia, Siddesh Shetty, Beena Joshi\",\"doi\":\"10.4103/ijmr.ijmr_2471_22\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background objectives: </strong>The prong 2 of 4 prong strategy introduced by the World Health Organization aims at averting unintended pregnancies among people living with HIV (PLHIV). 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引用次数: 0
摘要
背景目标:世界卫生组织推出的四管齐下战略中的第二管旨在避免艾滋病病毒感染者(PLHIV)意外怀孕。本系统综述旨在提供证据,说明基于设施的干预措施在提高现代避孕药具和双重避孕药具的采用率、减少未满足的计划生育(FP)需求和艾滋病毒感染者意外怀孕方面的效果:方法:纳入用英语发表的评估基于医疗机构的干预措施以整合人类免疫缺陷病毒(HIV)和计划生育的文章。通过对三个数据库(PubMed、Cochrane Library 和 Web of Science)和灰色文献进行电子和横向检索,确定了符合条件的研究。不关注/极少关注 FP 的 HIV 护理被视为参照研究。采用与设计相适应的工具对研究质量进行评估。描述性分析以表格形式呈现。双重方法的采用率、未满足的FP需求和意外怀孕被纳入荟萃分析,以随机效应模型、P值和I2值估算汇总的几率比(OR):搜索结果共 2112 条。在排除重复和不符合条件的文章后,有 17 篇文章符合审查条件,9 篇文章符合荟萃分析条件。采用双重避孕措施的汇总 OR 为 1.69 (1.14, 2.5) (P=0.008; I2=90%),未满足 FP 需求的汇总 OR 为 0.58 (0487, 0.69) (P解释结论:这项荟萃分析的结果表明,以医疗机构为基础,整合艾滋病毒和计划生育服务的干预措施确实提高了双重方法的采用率,减少了未满足的避孕需求,并对意外怀孕的发生率产生了保护性趋势。这种基于设施的整合将确保普及有效的避孕措施,并促进实现旨在消除艾滋病毒等流行病的可持续发展目标。
Health facility-based interventions and the uptake of contraception among people living with HIV: A systematic review & meta-analysis.
Background objectives: The prong 2 of 4 prong strategy introduced by the World Health Organization aims at averting unintended pregnancies among people living with HIV (PLHIV). This systematic review aimed to generate evidence on the effectuality of facility-based interventions in improving uptake of modern and dual contraception, for reducing unmet family planning (FP) needs and unintended pregnancies among PLHIV.
Methods: Articles evaluating facility-based interventions to integrate human immunodeficiency virus (HIV) and FP published in English language were included. Eligible studies were identified from electronic and lateral search from three databases (PubMed, Cochrane Library and Web of Science) and grey literature. HIV care with no/minimal focus on FP was considered a comparator. Quality was assessed using design-appropriate tools. Descriptive analysis was presented in tables. Uptake of dual methods, unmet FP needs and unintended pregnancies were included in the meta-analysis to estimate pooled odds ratio (OR) with random effect model, P and I2 values.
Results: The search yielded 2112 results. After excluding duplicates and unfit articles, 17 were found eligible for review and nine for meta-analysis. The pooled OR for uptake of dual contraception was 1.69 (1.14, 2.5) ( P =0.008; I2 =90%), for unmet FP needs was 0.58 (0487, 0.69) ( P <0.00001; I2 =0%) and for unintended pregnancies was 0.6 (0.32, 1.1) ( P =0.1, I2 =38%).
Interpretation conclusions: The results of this meta-analysis suggest that health facility-based interventions to integrate HIV and FP services do result in improved uptake of dual methods and reduce unmet need for contraception along with a protective trend on incidence of unintended pregnancies. Such facility-based integration would ensure universal access to effective contraception and facilitate in achieving Sustainable Development Goals that aim at ending epidemics like HIV.
期刊介绍:
The Indian Journal of Medical Research (IJMR) [ISSN 0971-5916] is one of the oldest medical Journals not only in India, but probably in Asia, as it started in the year 1913. The Journal was started as a quarterly (4 issues/year) in 1913 and made bimonthly (6 issues/year) in 1958. It became monthly (12 issues/year) in the year 1964.