Background: In settings where HIV prevalence is high, management of sexual and reproductive health is critical to reducing HIV transmission and maternal mortality. Integration of FP with HIV services is appropriate model for HIV therapy, HIV prevention and care with FP services in a resource limiting area like Ethiopia.

Objective: - The aim of the study was to determine the status of integration of family planning services with HIV treatment for women of reproductive age living with HIV attending ART in Special Zone of Oromia regional state, Ethiopia

Methods: The positivist paradigm, quantitative survey, explorative, descriptive and contextual research design with multiple data collection approaches from women living with HIV attending ART clinics and self-administrated structured questionnaires were used to collect data from focal persons, health managers, and health care providers working in the ART/PMTCT clinics in special zone of surrounding Finfinne of Oromia regional state in five health Centres. Simple random sampling computer-generated sample was selected by simple random sampling computer-generated method used to select 654 respondents and total census of 16 ART/PMTC services provides, focal persons and 15 Health offices/Bureau managers participated the study.

The returned questionnaires were checked for completeness, cleaned manually, coded and entered into EPI INFO 7.1.6 version and transferred to statistical Package for Social Sciences 23.0 for further analysis. Bivariate and multivariable logistic regressions analysis was used to identify factors associated with integration family planning with HIV services, demands for FP need and utilisation of FP/dual methods with the significant association at AOR with 95%CI too controlled effects of possible confounders from final model.

Result: - This study assessed the existing Integration of sexual reproductive health services with HIV treatment for WLHIV and attending ART in Oromia. Almost all women, 635(97.1%), preferred integration of sexual reproductive health (ISRH) with HIV services at the same facility. Also, most of the providers, 622(95%), were in favour of integrated FP-HIV services.

The factors related to the integration of family planning services with HIV treatment for women of childbearing age living with HIV were identified as educational status, occupational status, residence, discussed FP with health care providers, fertility desire, counselled FP, and CD4 count. The study assessed the magnitude of demand for family planning among HIV-infected women and established that the demand for FP needs of women of reproductive ages, living with HIV was 630 (96.3%), of which 530(84%) had met need for FP, followed by 100(16%) who had unmet need for FP while attending monthly ART drug refilling and were on follow up program.

The factors which were assumed to be increasing the demand for FP met the need of women of reproductive age living with HIV attending ART/PMTC were discussion with health care providers about FP; previous pregnancy; future fertility desire, having sexual partners and number of sexual partners were identified independent predictors of demands for FP.

The current family planning utilisation among women of reproductive age WLHIVs was 548(83.8%). The following were identified as determinants of current family planning among HIV-infected women in the area of study: open discussion on modern FP utilisation with health care providers; being knowledgeable about modern FP; number of sexual partners; previous unplanned pregnancy; partner HIV status and disclosure status of HIV to their family, Partner HIV status and disclosure status of HIV to their family had higher odds of FP utilisation among reproductive age WLHIV in Oromia region.

The prevalence of dual contraceptive utilisation was 425(73.8%), of which 343(80.7%) and 306 (72%) were consistent and sustained users of dual contraceptive method among women living with HIV attending ART clinics. The factors which were assumed to be increasing dual contraception method utilisations were: Open discussion on FP with health care providers, having received FP counselling about the efficacy of each method and side effects and the method mix available. Having received services from knowledgeable and comfortable ART providers for providing FP; integrated HIV services, unplanned previous pregnancy, partner HIV status and discloser status of HIV to the family added to the list.

Conclusion: The study explored the level of integration of family planning services with HIV treatment for women of childbearing age living with HIV. This study found that integration of family planning services with HIV services ranged from counselling on available FP in the ART room to provisions of family planning methods such as condom, pills and the injectable methods. This included the provision of implants in the ART rooms and referral of women’s in need of long-acting and permanent methods for consultation. The insertion of intrauterine device (IUD) was not part of the FP methods in the in this regard. The study findings strongly in favour of women of reproductive age living with HIV-centred integrated FP and HIV services offering multiple health services at the same facility, often by the same provider based on their needs in the study area.

Accordingly, strategies were developed based on the findings of the study which will benefit women of reproductive age living with HIV-centred integrated FP and HIV services strategies.

Key words: Antiretroviral therapy Family Planning HIV services, Integration, women living with HIV, service providers, strategies