Expert calls for integration of HIV, reproductive health services

Monday December 02 2019

KEMRI researcher Dr Maricianah Onono during a Kenya Science Congress meeting in Mombasa on November 20, 2019. PHOTO | FRANCIS MUREITHI | NATION MEDIA GROUP


There is need to integrate reproductive health services for women in public and private clinics, a reproductive health expert has said.

Dr Maricianah Onono said the integration of services such as family planning, HIV/ Aids and sexually transmitted infection (STI) testing will reduce the burden on women as tests will be done in a one stop shop.

Dr Onono said a study found that at least one in every five women seeking family planning services had an STI, raising concerns of high number of HIV cases.


 “There is need to integrate services to enable women seeking family planning services to get proper diagnosis for other diseases,” said Dr Onono who is a researcher at the Kenya Medical Research Institute.

 “Safe and effective contraception empowers women besides enhancing their economic and social development,” she added.


Some of the available family planning choices for women include IUD, implants, female sterilisation, oral and injectable methods.

Clinical trials comparing HIV incidence and contraceptives benefits in women began in 2015 and concluded in October last year. The trial was undertaken in Kenya, South Africa, Zambia and Eswatini (Swaziland).

At least 7,829 women of ages between 16-35 were involved in the trials dubbed ECHO using one of the three highly effective contraceptive methods like– Depot medroxyprogesterone (DMPA-IM), copper intrauterine device (IUD)

The trials revealed 397 out of the 7,829 women acquired HIV during the study.


“The overall rate of new HIV infections was 3.81 per cent per year,” revealed Dr Onono.

She said that the HIV prevalence among women is high.   

“Women participating in ECHO were seeking effective contraception. The trial found no substantial difference in HIV risk among the three different contraceptive methods evaluated,” added Dr Onono during last month’s Kenya Science Journalists congress in Mombasa.

The results underscored the importance of continued access to these three contraceptive methods, as well as expanded contraceptives choices. According to Dr Onono ECHO results are reassuring and distressing.

 “In spite of HIV treatment and prevention programmes and an individualised HIV prevention package, HIV incidence is high,” said Dr Onono.

She suggested that more aggressive HIV prevention efforts for women including PreP are needed.

On the positive side, ECHO has brought together family planning and HIV worlds of research, policy and programme together. However, STIs prevalence were high. World Health Organisation recommends moving away from syndromic approach.


“New screening, treatment, and prevention strategies for STIs are needed,” said Dr Onono.

She observed that this strategy is critical to address foetal and neonatal deaths, cervical cancer, infertility, increased HIV risks, physical, psychological and social impacts that compromise quality of life.

Prevention and treatment of HIV and other STIs, safe abortion services, detecting and preventing sexual and gender-based violence, managing reproductive cancers, counselling and services for modern contraceptives will be readily available to women.

Other benefits include availing antenatal, childbirth and postnatal care and counselling and services for women.