Comparación de dos modelos de asesoría en anticoncepción para mujeres VIH positivas desde una perspectiva de equidad en salud. Colombia 2015-2017

Objective: Compare, using an economic analysis two contraceptive counseling models for women living with HI, one that promotes integration between contraceptive and HIV services and the model used in Colombia where there is no service integration, complementing these results with the experiences of...

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Autores:: Gómez-Suárez, Marcela

Tipo de recurso:: Work document

Fecha de publicación:: 2019

Institución:: Universidad Nacional de Colombia

Repositorio:: Universidad Nacional de Colombia

Idioma:: spa

Description
Summary:	Objective: Compare, using an economic analysis two contraceptive counseling models for women living with HI, one that promotes integration between contraceptive and HIV services and the model used in Colombia where there is no service integration, complementing these results with the experiences of a group of women living with HIV when in contact with these services. Design: Mixed methods research with a quantitative approach using cost-effectiveness analysis from the Health System perspective and averted perinatal HIV infections as the outcome, and qualitative methodology using phenomenological research based on Max Van Manen´s existential parameters theory. Results: The integrated contraceptive counseling model shows better results in terms of cost-effectiveness, averting 3% additional perinatal HIV infections with an ICER of COP. 1.547.500 (USD 522). The use of contraceptive methods was the most crucial factor for the variability of the ICER. In the Montecarlo simulation at 10.000 iterations, the integrated model was still the most cost-effective alternative. The qualitative findings showed high unmet contraceptive needs among women living with HIV due to SRH access barriers that lead to incorrect contraceptive practices and high rates of unplanned pregnancies. Also, the findings highlight essential humans’ rights issues regarding post-partum sterilizations and other forms of institutional violence. Conclusion: This study presents evidence of the benefits that represent the integration of contraceptive counseling and HIV services to address unmet needs of women living with HIV by decreasing institutional and structural barriers, facilitating services and reducing stigma and discrimination among health care providers to improve access to SRHS based on human rights, so women independently of their HIV status can make their own reproductive decisions, free of violence and coercion.

Comparación de dos modelos de asesoría en anticoncepción para mujeres VIH positivas desde una perspectiva de equidad en salud. Colombia 2015-2017

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