Integrating Pregnancy Prevention Into an HIV Counseling and Testing Program in Pediatric Primary Care

Area of Science:

• Public Health
• Reproductive Health
• Infectious Disease Prevention

Background:

• Certified health educator (CHE)-based HIV counseling and testing traditionally focuses solely on HIV and sexually transmitted infection (STI) prevention.
• A gap exists in addressing reproductive life plans and unintended pregnancy within these established programs.

Purpose of the Study:

• To evaluate the integration of reproductive life plan assessment, pregnancy prevention counseling, and contraception referral into a CHE-based HIV testing program.
• To improve comprehensive sexual and reproductive health services for young patients.

Main Methods:

• A quality improvement initiative was conducted in an urban pediatric primary care clinic from February 2014 to January 2017.
• Certified health educators assessed sexual history, HIV risk, short-term pregnancy desire, and contraception use in patients aged 13-25.
• Data from a standardized questionnaire and administrative records were analyzed to track referrals and method initiation.

Main Results:

• Most patients (96%) did not desire short-term pregnancy.
• Contraception use was often ineffective or absent, with common method dissatisfaction.
• A significant proportion of referred female patients initiated more effective contraceptive methods (76%), while male patients opted for condoms (67%).
• Patients desiring pregnancy reported higher rates of previous pregnancy and STIs.

Conclusions:

• Integrating pregnancy prevention assessment and counseling into CHE-based HIV testing programs offers significant benefits.
• This approach can better serve patients at risk for both STIs/HIV and unintended pregnancy.
• It effectively links patients not desiring pregnancy to appropriate and more effective contraceptive methods.