This study explored barriers to and facilitators of using family planning services among HIV-positive men in Nyanza Province, Kenya. From May to June 2010, in-depth interviews were conducted with 30 men receiving care at 15 HIV clinics. The key barriers to the use of family planning included concerns about side effects of contraceptives, lack of knowledge about contraceptive methods, myths and misconceptions including fear of infertility, structural barriers such as staffing shortages at HIV clinics, and a lack of male focus in family planning methods and service delivery. The integration of family planning into HIV clinics including family planning counseling and education was cited as an important strategy to improve family planning receptivity among men. Integrating family planning into HIV services is a promising strategy to facilitate male involvement in family planning. Integration needs to be rigorously evaluated in order to measure its impact on unmet need for contraception among HIV-positive women and their partners and assure that it is implemented in a manner that engages both men and women. 1. Introduction Many studies have demonstrated the diversity and complexity of reproductive intentions among people living with HIV in sub-Saharan Africa, which are influenced by personal, health-related, sociocultural, socioeconomic, and gendered factors [1–6]. Often HIV infection changes but does not eliminate fertility desires [1]. Some HIV-positive individuals believe that having children gives them reasons to live [1, 7, 8], and some bear children to avoid raising suspicions of HIV infection [8, 9]. Still others want to replace children who have died due to HIV [1, 8, 10]. However, many HIV-positive individuals want to avoid pregnancy due to financial reasons and being satisfied with the number of children they have [6]. Other deterrents to having children include fears of orphaning a child, of vertical transmission of HIV, and of infecting a negative partner during conception [1, 6, 7]. Several studies have shown that fertility desires differ by gender, that one partner’s fertility intentions can impact the other’s, and that men and women are influenced differently by community opinions regarding HIV and reproduction [1, 5, 8, 11, 12]. Unmet need for contraception and unintended pregnancy are prevalent among HIV-positive women and couples in sub-Saharan Africa [13, 14]. Based on evidence of cost-savings and demonstrated effectiveness of contraception in averting HIV-positive births [15, 16], the World Health Organization/United Nations Population
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