Table 1

Descriptions of included studies and reported outcomes

StudyLocation, setting and target groupInterventionStudy designSample sizeOutcomes
Church et al 28 and
Church et al 27 		Location: Manzini, Swaziland
Target group:
HIV-positive women and men attending an HIV clinic		Among the four models of HIV care evaluated, the most fully integrated clinic provided reproductive health services including FP, STI screening and care, and Pap smears, theoretically provided by one provider in one room (model A). A partially integrated clinic provided HIV and reproductive health services, FP, STI and Pap smears by different providers in different rooms within the same building (model B). A third partially stand-alone model provided HIV treatment on the campus of a larger district hospital where reproductive health services were provided in different buildings (model C). A fourth fully stand-alone HIV clinic did not offer reproductive health services (model D). Study design: Cross-sectional
Unit of analysis: Individual
Selection of participants: Systematic random sampling		 Sample size:
Total: 602 men and women; 475 women
A: 71 men and women
B: 163 men and women
C: 178 men and women
D: 190 men and women		 1. Pap smear since testing HIV positive (women)
A: 35%, B: 11%, C: 14%, D: 10%
2. Sexual health screening since testing HIV positive (men and women)
A: 45%, B: 57%, C: 76%, D: 42%
3. Counselling on condom use (men and women)
A: 76%, B: 78%, C: 95%, D: 87%
4. Provision of condom use (men and women)
A: 41%, B: 39%, C: 56%, D: 77%
5. Advice on sexual health (men and women)
A: 16%, B: 12%, C: 16%, D: 11%
6. Mean number of providers seen during visit (men and women)
A: 2.5, B: 1.8, C: 2.8, D: 2.2
7. Mean number of reproductive health and HIV services accessed (men and women)
A: 3.1, B: 2.3, C: 3.1, D: 2.7
8. Clients who would have liked to receive STI services (men and women)
A: 44%, B: 48%, C: 59%, D: 41%
9. Client satisfaction (men and women)
Compared with model D, the aOR for mean satisfaction score≥4 was lower in models B (aOR 0.45, 95% CI 0.25 to 0.81) and C (aOR 0.53, 95% CI 0.31 to 0.90) and not statistically significantly different from model 1 (aOR 0.84, 95% CI 0.40 to 1.78)
10. Number of referrals for STI services during visit (men and women)
Very low for all sites: A: 1, B: 2, C: 1, D:1
Coyne et al 25 Location: Slough, UK
Target group:
HIV-positive women attending an HIV clinic		The Garden Clinic, for HIV-positive women, started a specific clinic (FP Plus) to provide HIV-positive women clients with screening for STIs, contraception, pre-conception counselling and cervical cytology. The Garden Clinic already worked on a model of integrated sexual healthcare, and FP Plus was staffed by doctors and senior nurses trained in both STI management and FP. Study design: Serial cross-sectional
Unit of analysis: Individual
Selection of participants: Non-random		 Sample size:
Total: 60 women
Before: 30 women
After: 30 women		 1. Using condom only as contraception (women)
Before: 30%
After: 7%
2. Cervical cytology in 12 months (women)
Before: 63%
After: 83%
3. Method of contraception recorded (women)
Before: 63%
After: 77%
4. Sexual history recorded in 4 weeks (women)
Before: 77%
After: 97%
5. STI screen offered in 6 months (women)
Before: 70%
After: 83%
Hamlyn et al 26 Location: London, UK
Target group:
HIV-positive adults attending an HIV clinic		At the Caldecot Centre, an audit showed the need for a specific sexual health clinic for HIV-positive patients. Nurse-led STI clinics were set up on both a booked appointment and an emergency walk-in basis. Study design: Serial cross-sectional
Unit of analysis: Individual
Selection of participants: Non-random		 Sample size:
Total: 200 men and women
Before: 100 men and women; 34 women
After: 100 men and women; 48 women		 1. Positive STI result at first appointment (men and women)
I: 23 (44%), C: 12 (31%)
2. Positive STI result at annual STI screen (men and women)
I: 15 (33%), C: 10 (38%)
3. STI screen at first appointment (men and women)
I: 52%, C: 39%, I vs C NS (p=0.065)
4. Annual STI screen (men and women)
I: 46%, C: 26%, I vs C Sig (p=0.003)
5. Screening for hepatitis B (men and women)
I: 94%, C: 93%
6. Annual cervical cytology (women)
I: 64%, C: 44%, I vs C NS (p=0.129)
7. Documented annual sexual health discussion (men and women)
I: 70%, C: 37%, I vs C Sig (p<0.0001)

  • aOR, adjusted OR; C, comparison group; FP, family planning; I, intervention group; NS, not significant; Sig, significant; STI, sexually transmitted infection.