Family planning, by informed choice

The line between HIV prevention and reproductive choice is drawn on paper, not in the lives of clients. KVP women who walk in for an HIV test routinely want to discuss contraception, fertility, and pregnancy planning — and they want to do it once, in one place, with one provider.

EpiC integrated family planning (FP) counselling into the standard KVP contact in 2022. Counsellors were trained in the full method mix, and commodity supply was negotiated through council pharmacies so that no client left a contact carrying a referral she would not redeem.

Across the six councils, 1,420 FP counselling sessions were delivered and 980 methods were initiated. Fifty-eight percent of initiators chose a long-acting reversible method (implant or IUD); 34 percent chose injectables; the remainder chose pills or condoms as a primary method.

Integration did not displace HIV outcomes. Testing volumes rose 8 percent year-on-year and same-week linkage held above 95 percent.

Integrated services are not free. They require more counsellor time per contact, more commodities to manage, and more training to maintain quality. The trade-off is a client experience that respects the full reality of a person's life — and outcomes that vindicate the investment.