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Revathy R, Chaurasia H, Shetty S, Joshi B. Health facility-based interventions and the uptake of contraception among people living with HIV: A systematic review & meta-analysis. Indian J Med Res 2023; 158:483-493. [PMID: 38143434 PMCID: PMC10878490 DOI: 10.4103/ijmr.ijmr_2471_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Indexed: 12/26/2023] Open
Abstract
BACKGROUND OBJECTIVES The prong 2 of 4 prong strategy introduced by the World Health Organization aims at averting unintended pregnancies among people living with HIV (PLHIV). This systematic review aimed to generate evidence on the effectuality of facility-based interventions in improving uptake of modern and dual contraception, for reducing unmet family planning (FP) needs and unintended pregnancies among PLHIV. METHODS Articles evaluating facility-based interventions to integrate human immunodeficiency virus (HIV) and FP published in English language were included. Eligible studies were identified from electronic and lateral search from three databases (PubMed, Cochrane Library and Web of Science) and grey literature. HIV care with no/minimal focus on FP was considered a comparator. Quality was assessed using design-appropriate tools. Descriptive analysis was presented in tables. Uptake of dual methods, unmet FP needs and unintended pregnancies were included in the meta-analysis to estimate pooled odds ratio (OR) with random effect model, P and I2 values. RESULTS The search yielded 2112 results. After excluding duplicates and unfit articles, 17 were found eligible for review and nine for meta-analysis. The pooled OR for uptake of dual contraception was 1.69 (1.14, 2.5) ( P =0.008; I2 =90%), for unmet FP needs was 0.58 (0487, 0.69) ( P <0.00001; I2 =0%) and for unintended pregnancies was 0.6 (0.32, 1.1) ( P =0.1, I2 =38%). INTERPRETATION CONCLUSIONS The results of this meta-analysis suggest that health facility-based interventions to integrate HIV and FP services do result in improved uptake of dual methods and reduce unmet need for contraception along with a protective trend on incidence of unintended pregnancies. Such facility-based integration would ensure universal access to effective contraception and facilitate in achieving Sustainable Development Goals that aim at ending epidemics like HIV.
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Affiliation(s)
- R Revathy
- Department of Operational and Implementation Research, Regional Resource Hub-Health Technology Assessment, ICMR-National Institute for Research in Reproductive and Child Health, Mumbai, Maharashtra, India
| | - Himanshu Chaurasia
- Department of Operational and Implementation Research, Regional Resource Hub-Health Technology Assessment, ICMR-National Institute for Research in Reproductive and Child Health, Mumbai, Maharashtra, India
| | - Siddesh Shetty
- Department of Operational and Implementation Research, Regional Resource Hub-Health Technology Assessment, ICMR-National Institute for Research in Reproductive and Child Health, Mumbai, Maharashtra, India
| | - Beena Joshi
- Department of Operational and Implementation Research, Regional Resource Hub-Health Technology Assessment, ICMR-National Institute for Research in Reproductive and Child Health, Mumbai, Maharashtra, India
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Jemberie A, Aynalem BY, Zeleke LB, Alemu AA, Tiruye TY. Dual Contraceptive Method Utilization and Associated Factors Among HIV Positive Women Attending ART Clinic in Finote-Selam Hospital: Cross-Sectional Study. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:2639-2646. [PMID: 37027108 PMCID: PMC10501923 DOI: 10.1007/s10508-023-02593-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Revised: 03/06/2023] [Accepted: 03/19/2023] [Indexed: 05/11/2023]
Abstract
Worldwide, the human immune deficiency virus is the leading cause of death for women of childbearing age. Around two-thirds of all pregnant women living with the human immune deficiency virus experience an unintended pregnancy. The correct and consistent use of dual contraceptive methods is important to prevent unintended pregnancy and transmission of sexually transmitted infections. However, little is known about the utilization of dual contraceptive methods among HIV-infected women. Thus, this study aimed to assess dual contraceptive utilization and associated factors among HIV-positive women attending antiretroviral therapy (ART) in Finote Selam Hospital, Northwest Ethiopia. Facility-based cross-sectional study design was conducted from September 1 to October 30, 2019, in Finote Selam Hospital among HIV-positive women. A systematic random sampling technique was used to select study participants and the data were gathered by an interviewer-administered structured pretested questionnaire. Factors associated with dual contraceptive use were identified through binary logistic regression. Finally, a p-value < 0.05 was taken as a cutoff point to declare a significant association, and the direction and strength of the association were determined by the adjusted odds ratio. The study showed that 21.8% of HIV-positive women attending ART care in Finote Selam Hospital utilize dual contraceptive methods. Dual contraceptive utilization was significantly associated with having a child (AOR: 3.29; CI 1.45, 7.47), having family support to use dual contraceptives (AOR: 3.02; CI 1.39, 6.54), having multiple sexual partners (AOR: 0.11; CI 0.05, 0.22), and urban residence (AOR: 3.64; 1.82, 7.3). The study revealed that low utilization of dual contraceptive methods. This will continue major public health problems in the study area unless future interventions conducted.
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Affiliation(s)
- Anteneh Jemberie
- Health Science College, Debre Markos University, Debre Markos, 269, Ethiopia
| | | | - Liknaw Bewket Zeleke
- Health Science College, Debre Markos University, Debre Markos, 269, Ethiopia
- School of Women's and Children's Health, University of New South Wales Sydney, Kensington, Australia
| | - Addisu Alehegn Alemu
- School of Women's and Children's Health, University of New South Wales Sydney, Kensington, Australia
| | - Tenaw Yimer Tiruye
- Health Science College, Debre Markos University, Debre Markos, 269, Ethiopia
- Cancer Epidemiology and Population Health Research Group, Allied Health and Human Performance, University of South Australia, Adelaide, Australia
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Medley A, Tsiouris F, Pals S, Senyana B, Hanene S, Kayeye S, Casquete RR, Lasry A, Braaten M, Aholou T, Kasonde P, Chisenga T, Mweebo K, Harris TG. An Evaluation of an Enhanced Model of Integrating Family Planning Into HIV Treatment Services in Zambia, April 2018-June 2019. J Acquir Immune Defic Syndr 2023; 92:134-143. [PMID: 36240748 PMCID: PMC10913187 DOI: 10.1097/qai.0000000000003111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 09/13/2022] [Indexed: 01/21/2023]
Abstract
BACKGROUND We designed and implemented an enhanced model of integrating family planning (FP) into existing HIV treatment services at 6 health facilities in Lusaka, Zambia. METHODS The enhanced model included improving FP documentation within HIV monitoring systems, training HIV providers in FP services, offering contraceptives within the HIV clinic, and facilitated referral to community-based distributors. Independent samples of women living with HIV (WLHIV) aged ≥16 years were interviewed before and after intervention and their clinical data abstracted from medical charts. Logistic regression models were used to assess differences in key outcomes between the 2 periods. RESULTS A total of 629 WLHIV were interviewed preintervention and 684 postintervention. Current FP use increased from 35% to 49% comparing the pre- and postintervention periods ( P = 0.0025). Increased use was seen for injectables (15% vs. 25%, P < 0.0001) and implants (5% vs. 8%, P > 0.05) but not for pills (10% vs. 8%, P < 0.05) or intrauterine devices (1% vs. 1%, P > 0.05). Dual method use (contraceptive + barrier method) increased from 8% to 18% ( P = 0.0003), whereas unmet need for FP decreased from 59% to 46% ( P = 0.0003). Receipt of safer conception counseling increased from 27% to 39% ( P < 0.0001). The estimated total intervention cost was $83,293 (2018 USD). CONCLUSIONS Our model of FP/HIV integration significantly increased the number of WLHIV reporting current FP and dual method use, a met need for FP, and safer conception counseling. These results support continued efforts to integrate FP and HIV services to improve women's access to sexual and reproductive health services.
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Affiliation(s)
- Amy Medley
- U.S. Centers for Disease Control and Prevention, Division of Global HIV and TB, Atlanta, GA
| | - Fatima Tsiouris
- ICAP at Columbia University, Mailman School of Public Health, New York, NY
| | - Sherri Pals
- U.S. Centers for Disease Control and Prevention, Division of Global HIV and TB, Atlanta, GA
| | - Brenda Senyana
- ICAP at Columbia University, Mailman School of Public Health, New York, NY
| | - Susan Hanene
- ICAP at Columbia University, Mailman School of Public Health, New York, NY
| | - Shadrick Kayeye
- ICAP at Columbia University, Mailman School of Public Health, New York, NY
| | | | - Arielle Lasry
- U.S. Centers for Disease Control and Prevention, Division of Global HIV and TB, Atlanta, GA
| | - Mollie Braaten
- ICAP at Columbia University, Mailman School of Public Health, New York, NY
| | - Tiffiany Aholou
- U.S. Centers for Disease Control and Prevention, Division of Global HIV and TB, Atlanta, GA
| | - Prisca Kasonde
- ICAP at Columbia University, Mailman School of Public Health, New York, NY
| | | | - Keith Mweebo
- U.S. Centers for Disease Control and Prevention, Division of Global HIV and TB, Lusaka, Zambia
| | - Tiffany G. Harris
- ICAP at Columbia University, Mailman School of Public Health, New York, NY
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Haile D, Lagebo B. Magnitude of dual contraceptive method utilization and the associated factors among women on antiretroviral treatment in Wolaita zone, Southern Ethiopia. Heliyon 2022; 8:e09595. [PMID: 35677405 PMCID: PMC9168601 DOI: 10.1016/j.heliyon.2022.e09595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 11/11/2021] [Accepted: 05/24/2022] [Indexed: 10/26/2022] Open
Abstract
Background Expanding the contraceptive options based on desires of families and personal context is critical to address the needs of users. For instance, dual contraceptive methods were recommended for people with the human immunodeficiency virus (HIV) patients to prevent HIV transmission, other sexually transmitted infections (STIs), and unintended pregnancies. Disclosure is one of the strategies to reduce the stigma related to HIV and use of contraception clandestinely. However, there is a dearth of evidence regarding the magnitude of and the factors affecting dual contraceptive method utilization among sexually active women on antiretroviral treatment (ART).There is limited evidence regarding the association between disclosure to community and dual contraceptive utilization. Thus, the aim of this study is to assess the magnitude of dual contraceptive utilization and its associated factors among ART patients in this study area. Objective the primary objective of this study was to assess the prevalence of the dual contraceptive use. Methods A facility-based cross-sectional study design was employed to collect data from a total of 556 respondents by using a semi-structured questionnaire. Data were entered in EpiData version 3.1 and exported to SPSS version 20 for analysis. Binary logistic regression was applied to determine the magnitude of dual contraceptive utilization and the factors associated with it. Variables with p-value<0.25 were considered as candidate for multivariable logistic regression. In multivariate logistic regression, variables with a p-value < 0.05 were reported to be statistically significant. Result The magnitude of dual contraceptive utilization was 28.6% (95%CI: 24.8, 32.4). HIV sero-status disclosure to community (AOR:7.1 (95%CI: 4.8,10.2)), disclosure to sexual partners (AOR:3.1 (95%CI:1.2,7.8)), sexual activity (AOR: 4.7 (95%CI: 2.5, 10.0)), fertility desire (AOR:4.3 (95%CI:2.4,7.5)), history of STI (AOR: 3.2 (95%CI: 1.6, 6.6)), partners' sero-HIV status (AOR:3.7 (95%CI:1.7,8.1)), and discussion with sexual partners about dual contraceptive methods (AOR:5.8 (95%CI:2.2,8.5)) were significantly associated with dual contraceptive utilization. Conclusion This study found that a substantial number of mothers did not use dual contraceptive methods. Disclosure to community increases the use of dual contraceptive methods. Integrating the family planning with STI and ART care, strengthening the partner involvement during posttest counseling is recommended to increase the uptake of dual contraceptive methods utilization. Moreover, encouraging PLWHIV to disclose their HIV status to the community should be advocated.
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Affiliation(s)
- Dereje Haile
- Reproductive Health and Nutrition Department, School of Public Health, College of Medicine and Health Science, Wolaita Sodo University, Sodo, Ethiopia
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Shri N, Muhammad T. Association of intimate partner violence and other risk factors with HIV infection among married women in India: evidence from National Family Health Survey 2015-16. BMC Public Health 2021; 21:2105. [PMID: 34789185 PMCID: PMC8597306 DOI: 10.1186/s12889-021-12100-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 10/19/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Human immunodeficiency virus (HIV) infection remains an important public health concern in many countries. It is fuelled by gender inequality and disparity, which has resulted in a fundamental violation of women's human rights. This study aims to find out the association of intimate partner violence (IPV) and other risk factors with the prevalence of HIV infection among married women in India. METHODS This study is based on data from the India National Family Health Survey (2015-16). Bivariate analysis has been performed to estimate the prevalence of HIV. Logistic regression analysis is conducted to find out the association between IPV, factors such as having alcoholic husband and lifetime partner, and HIV infection among currently married women. RESULTS Married women who had faced physical, sexual, and emotional violence from their husbands/partners were almost twice more likely to have tested HIV positive compared to married women who did not face violence [OR: 2.14, CI: 1.08-4.50]. The odds of testing for HIV positive was significantly higher among the married women experiencing IPV and having alcoholic husband [OR: 4.48, CI: 1.87-10.70] than those who did not experience IPV and had non-alcoholic husband. The use of condom did not show any significant association with HIV infection. Again, having more than one lifetime partner had a positive association with HIV infection compared to those with one partner [OR: 2.45, CI: 1.21-4.16]. CONCLUSIONS The study revealed that factors such as experiencing all types of IPV, having an alcoholic husband, increased number of lifetime partners, being sexually inactive, belonging to vulnerable social groups, and urban place of residence are important risk factors of HIV infection among married women in India. The results also suggest that gender-based violence and an alcoholic husband may represent a significant factor of HIV infection among married women and interventions should on focus such vulnerable populations.
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Affiliation(s)
- Neha Shri
- International Institute for Population Sciences, Mumbai, Maharashtra India 400088
| | - T. Muhammad
- International Institute for Population Sciences, Mumbai, Maharashtra India 400088
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Dual Contraceptive Use and Factor Associated with People Living with HIV/AIDS: A Systematic Review and Meta-Analysis. Infect Dis Obstet Gynecol 2021; 2021:5440722. [PMID: 34434041 PMCID: PMC8382549 DOI: 10.1155/2021/5440722] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 08/01/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction A dual contraceptive method is the usage of any modern contraceptive method with male or female condoms which could lower sexually transmitted diseases and unwanted pregnancy. Ethiopian standard utilization of dual contraceptive is low. The hassle is more severe for HIV/AIDS-infected people. Therefore, this review was aimed at assessing dual contraceptive utilization and factor associated with people living with HIV/AIDS in Ethiopia. Method International databases (PubMed/MEDLINE, Hinari, Embase, African Journals Online, Scopus, and Google Scholar) and Ethiopian university repository online have been covered in this review. Microsoft Excel was used for extraction, and the Stata 14 software program was used for analysis. We detected the heterogeneity between studies using the Cochran Q statistic and I2 test. Publication bias was assessed by funnel plot and Egger's and Begg's tests. Result The overall prevalence of dual contraceptive use among people living with HIV/AIDS was 27.73% (95% CI: 20.26-35.19) in Ethiopia. Discussion with the partner (OR: 3.78, 95% CI: 3.08-4.69), HIV status disclosure to the spouse/partner (OR: 2.810, 95% CI: 2.26-3.48), postdiagnosis counseling (OR: 5.00, 95% CI: 3.71-6.75), schooling in secondary and above education (OR: 3.78, 95% CI: 2.41-5.93), partner involvement in counseling (OR: 2.76, 95% CI: 1.99-3.82), urban residence (OR: 2.84, 95% CI 2.03-3.94), and having no fertility desire (OR: 4.01, 95% CI 2.91-5.57) were significantly associated with dual contraceptive use. Conclusion Dual contraceptive utilization among people living with HIV/AIDS was found to be low in Ethiopia. This will be a significant concern unless future intervention focuses on rural residence, involvement of the partner in postdiagnosis counseling, encouraging the people living with HIV/AIDS to disclose HIV status, and discussion with the partner. Providing counseling during the antenatal and postnatal period also enhances dual contraceptive use.
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Ayele AD, Kassa BG, Beyene FY, Sewyew DA, Mihretie GN. Dual contraceptive utilization and determinant factors among HIV positive women in Ethiopia: a systematic review and meta-analysis, 2020. Contracept Reprod Med 2021; 6:19. [PMID: 34193304 PMCID: PMC8247245 DOI: 10.1186/s40834-021-00161-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 04/13/2021] [Indexed: 11/16/2022] Open
Abstract
Background Dual contraceptive is the use of a barrier like condom along with any modern contraceptive methods which has double significance for the prevention STI including HIV and unintended pregnancy. The prevalence and determinants of dual contraceptive utilization described by different studies were highly inconsistent in Ethiopia. Therefore, this systematic review and meta-analysis aimed to estimate the pooled prevalence and determinants of dual contraceptive utilization among HIV positive women in Ethiopia. Methods International database mainly Pub Med, Google scholar, HINARI, EMBASE, Cochrane Library, AJOL was applied to identify original studies. STATA software version 14 was applied to analyze the pooled prevalence of dual contraceptive. I2 test statistics was computed to check the presence of heterogeneity across the studies and eggers test was used to identify publication bias. The pooled prevalence of dual contraceptive utilization was estimated by using a random effects model. The associations between determinants and dual contraceptive utilization were evaluated by using both random and fixed effect models. Result A total 9 studies with 9168 HIV positive women were enrolled in this study. The pooled prevalence of dual contraceptive utilization among HIV positive women in Ethiopia was 26.14% (95% CI 21.20–31.08). Disclosure of HIV status (OR = 4.18,95%CI:2.26–7.72), partner involvement in post-test counselling (OR = 2.31,95%CI:1.63–3.25), open discussion about dual contraceptive with partner (OR = 4.27 95% CI:1.69–10.77), provision of counselling on dual contraceptives by health care provider (OR = 4.47,95% CI:3.81–5.24) and CD4 count > 350 cells/ mm3 (OR = 3.87,95%CI:3.53–4.23) were among the significant factors associated with dual contraceptive utilization. Conclusion The overall prevalence of dual contraceptive utilization among HIV positive women was significantly low. Disclosure of HIV status, partner involvement in post-test counselling, open discussion about dual contraceptive with partner, counselling on dual contraceptive by health care provider and CD4 count > 350 cells/ mm3 were positively affect dual contraceptive utilization. This study implies the need to develop plans and policies to improve partner involvement posttest counseling, integrate the counseling and provision of dual contraceptive at ART clinic at each level of health system. Supplementary Information The online version contains supplementary material available at 10.1186/s40834-021-00161-w.
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Affiliation(s)
- Alemu Degu Ayele
- Department of Midwifery, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia.
| | - Bekalu Getnet Kassa
- Department of Midwifery, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Fentahun Yenealem Beyene
- Department of Midwifery, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Dagne Addisu Sewyew
- Department of Midwifery, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Gedefaye Nibret Mihretie
- Department of Midwifery, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
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Tilahun Y, Bala ET, Bulto GA, Roga EY. Dual Contraceptive Utilization and Associated Factors Among Reproductive-Age Women on Anti-Retroviral Therapy at Hospitals in Central Ethiopia. Risk Manag Healthc Policy 2021; 14:619-627. [PMID: 33623452 PMCID: PMC7894880 DOI: 10.2147/rmhp.s290362] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 02/06/2021] [Indexed: 11/23/2022] Open
Abstract
Background Ethiopia is one of the Sub-Saharan African countries with an increasingly risky sexual practice and mostly affected by the Human Immunodeficiency Virus (HIV) epidemic. Dual protection is an important preventive approach which can prevent both unwanted pregnancy and sexually transmitted infections including HIV/AIDS. Therefore, this study aimed to assess the dual contraceptive utilization and associated factors among reproductive-age women on Anti-Retroviral Therapy (ART) in central Ethiopia. Methods An-institution based cross-sectional study was conducted among 311 women on ART at public hospitals of West Shewa Zone from June to September 2019. A systematic random sampling technique was used to select the study participants. A pretested structured interviewer-administered questionnaire was used for data collection. The data were entered into Epi data version 3.1 and exported to IBM SPSS statistical software version 25 for analysis. Bivariate and multivariable logistic regression analysis were computed. Odds ratio along with 95% confidence interval was computed to ascertain the association. Results The prevalence of dual contraceptive utilization among women on ART was 21.4% (95% CI: 16.8-25.9). Age of respondents between 15 and 24 years [AOR=8.35, (95% CI: 3.12-17.78)], living in urban [AOR=2.59, 95% CI: 1.15-4.22], separated women [AOR=2.28, 95% CI (1.26-5.04)], had post-diagnosis counselling on family planning [AOR=5.33, 95% CI: 1.52-18.68], disclosed HIV status [AOR=5.98, 95% CI: 1.63-21.93], freely discuss with their husband [AOR=4.22, 95% CI, 1.84-12.36], have no fertility desire [AOR=2.46, (95% CI: 1.34-6.44)] were significantly associated with dual contraceptive utilization. Conclusion and Recommendation The overall magnitude of dual contraceptive utilization among women on ART was found to be low. Factors like age, residence, marital status, post-diagnosis counselling, disclosure of HIV status, and free discussion with husband were significantly associated with dual contraceptive method utilization. Therefore, it is necessary to expand the range of strategies and tools available to married and single women's for protecting themselves from being infected with other strains and pregnancy. The concerned stakeholders also should emphatically consider those identified factors for intervention.
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Affiliation(s)
- Yohannes Tilahun
- Disease Prevention and Control Division, Addis Ababa Health Bureau, Addis Ababa, Ethiopia
| | - Elias Teferi Bala
- Department of Public Health, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia
| | - Gizachew Abdissa Bulto
- Department of Midwifery, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia
| | - Ephrem Yohannes Roga
- Department of Midwifery, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia
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Amare G, Cherie N, Mekonen AM. Dual Contraceptive Use and Associated Factors Among Reproductive Age Group on Antiretroviral Therapy in Borena District, Northeast Ethiopia: A Cross-Sectional Study. HIV AIDS (Auckl) 2021; 13:107-114. [PMID: 33531844 PMCID: PMC7847380 DOI: 10.2147/hiv.s289045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 12/30/2020] [Indexed: 11/23/2022] Open
Abstract
Background Dual contraceptive method use is defined as the use of any modern contraceptive method with a condom for the reduction of mother-to-child transmission of HIV and sexually transmitted infections between sexual partners. The goal of this study was to assess the proportion and factors associated with dual contraceptive use among reproductive age women on antiretroviral therapy in Borena district, Northeast Ethiopia. Objective To assess the proportion of dual contraceptive use and associated factors among the reproductive age women on antiretroviral therapy in Borena district, Northeast Ethiopia. Methods An institutional-based cross-sectional study was conducted among HIV positive reproductive age group women on antiretroviral therapy in Borena district from February 1 to March 1, 2020. A systematic random sampling technique was used to include 417 study participants. A structured interviewer-administered questionnaire was used to collect the data. A binary logistic regression model was used to identify the factors associated with dual contraceptive use. Odds ratio with 95% confidence interval (CI) and P-value were calculated to assess the strength of association. Results The results showed that 19.4% of the HIV positive reproductive age group on antiretroviral therapy were using dual contraceptive method. Urban area (AOR=3.66, 95% CI=1.66-8.09), educated to secondary education and above (AOR=3.54, 95% CI=1.29-9.76), those who have no desire to have a child (AOR=4.41, 95% CI=2.66-7.59), those with partners whose HIV status was negative (AOR=4.96, 95% CI=2.66-12.02) and those with partners whose HIV status was positive (AOR=2.45, 95% CI=1.25-4.81) were more likely to use the dual contraception method. Conclusion This study showed that the proportion of dual contraceptive use was found to be low in accordance with the WHO recommendation. Therefore increased awareness on the advantages of dual contraception and knowing partner's HIV status is important.
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Affiliation(s)
- Gashaw Amare
- Department of Reproductive Health and Family Health, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Amhara, Ethiopia
| | - Niguss Cherie
- Department of Reproductive Health and Family Health, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Amhara, Ethiopia
| | - Asnakew Molla Mekonen
- Department of Health Systems Management, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Amhara, Ethiopia
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Abay F, Yeshita HY, Mekonnen FA, Sisay M. Dual contraception method utilization and associated factors among sexually active women on antiretroviral therapy in Gondar City, northwest, Ethiopia: a cross sectional study. BMC Womens Health 2020; 20:26. [PMID: 32050961 PMCID: PMC7017555 DOI: 10.1186/s12905-020-0890-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Accepted: 01/24/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mother to child transmission is responsible for 90% of child infection with human immune deficiency virus (HIV). Dual contraceptive use is one of the best actions to prevent mother's human immune deficiency virus transmission to her child and partner. This study aimed at assessing the prevalence and factors associated with dual contraceptive use among sexually active women on antiretroviral therapy in Gondar City, northwest, Ethiopia. METHODS An institution based cross sectional study was conducted in Gondar City public health facilities from December 1 to 31, 2018. Systematic random sampling technique was utilized to include 563 study participants. Data were collected by interview using a structured questionnaire. Descriptive analysis was made to compute mean, median and proportion. Finally, multivariable logistic regression model was fitted to identify the factors associated with dual contraceptive method utilization. Analysis was performed by using Statistical Package for Social Sciences (SPSS) software version 20. RESULTS The overall prevalence of dual contraceptive method utilization among sexually active women on antiretroviral therapy was 28.8% (95% CI: 24.9, 32.7). Women aged 35-49 years (Adjusted odds ratio (AOR): 6.99; 95% CI: 3.11, 15.71)), who lived in urban areas (AOR: 4.81; 95% CI: 2.04, 11.31), attended secondary and above education (AOR: 4.43; 95% CI: 1.92, 10.22), and disclosed HIV status to sexual partners (AOR: 9.84; 95% CI: 3.48, 27.81) were more likely to use dual contraceptive method. CONCLUSION In this study, the proportion of women who utilized dual contraceptive method was low. Age, place of residence, educational status and disclosure of HIV status were factors associated with dual contraceptive use. Therefore, providing education about the advantages of disclosing HIV status to sexual partners and strengthening of counseling about the advantages of dual contraceptive use will be helpful in enhancing the use of dual contraceptive method among sexually active women on antiretroviral therapy.
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Affiliation(s)
- Fewuze Abay
- Department of Reproductive Health, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Hedija Yenus Yeshita
- Department of Reproductive Health, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Fantahun Ayenew Mekonnen
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mekonnen Sisay
- Department of Human Nutrition, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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11
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Gausi B, Chagomerana MB, Tang JH, Hosseinipour MC, Haddad LB, Hannock T, Phiri S. Human Immunodeficiency Virus Serodiscordance and Dual Contraceptive Method Use Among Human Immunodeficiency Virus-infected Men and Women in Lilongwe, Malawi. Sex Transm Dis 2019; 45:747-753. [PMID: 30303948 PMCID: PMC6200388 DOI: 10.1097/olq.0000000000000868] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Some human immunodeficiency virus (HIV) serodiscordant couples are faced with the dual challenge of preventing HIV transmission to the uninfected partner and avoiding unintended pregnancy. Therefore, we hypothesized that serodiscordance is associated with dual method use at last sex. METHODS We analyzed data from a cross-sectional survey of HIV-infected men and women attending 2 ante-retroviral therapy clinics in Lilongwe, Malawi. We used Fisher exact test and Wilcoxon rank sum to assess for associations between serodiscordance, covariates, and dual method use. Multivariable logistic regression was used to estimate the adjusted odds ratio (aOR) and 95% confidence intervals (CI) of dual method use at last sex, comparing serodiscordant to seroconcordant relationships. Separate analyses were conducted for men and women. RESULTS We surveyed 253 HIV-infected men, of which 44 (17.4%) were in a known serodiscordant relationship and 63 (24.9%) were using dual methods at last sex. Likewise, among 302 HIV-infected women surveyed, 57 (18.9%) were in a known serodiscordant relationship, and 80 (26.5%) were using dual method at last sex. Serodiscordance was not significantly associated with dual method use at last sex for among HIV-infected men (aOR, 0.62; 95% CI, 0.27-1.44) or women (aOR, 1.21; 95% CI, 0.59-2.47). CONCLUSION Dual method use was low among all HIV-infected individuals, irrespective of their partner's HIV status. Given these findings, we recommend greater efforts to encourage HIV providers to counsel their patients about the importance of dual method use to prevent both unintended pregnancy and sexually transmitted infections.
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Affiliation(s)
| | | | | | | | - Lisa B Haddad
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Emory University, Atlanta GA
| | - Tweya Hannock
- The Lighthouse Trust, Kamuzu Central Hospital, Lilongwe, Malawi
| | - Sam Phiri
- The Lighthouse Trust, Kamuzu Central Hospital, Lilongwe, Malawi
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Reta MM, Tessema GA, Shiferaw G. Prevalence of dual contraceptive use and associated factors among HIV positive women at University of Gondar Hospital, Northwest Ethiopia. BMC Res Notes 2019; 12:36. [PMID: 30658683 PMCID: PMC6339424 DOI: 10.1186/s13104-019-4053-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 01/08/2019] [Indexed: 11/15/2022] Open
Abstract
Objective Dual contraceptive is the use of male condom besides any modern contraceptive. It reduces parent to child transmission of HIV and other sexually transmitted infections between partners. The aim of this study was to investigate the prevalence and associated factors of dual contraceptive use among HIV positive women at University of Gondar Hospital, North West Ethiopia. Result The prevalence of dual contraceptive use was found to be 13.2% (95% CI 10.5, 16.0). Partner involvement in post-test counseling [AOR = 3.11 (95% CI = 1.74, 5.57)], open partner discussion on using dual contraceptive [AOR = 7.84, 95% CI (4.26, 14.42)], provision of counseling about dual contraception [AOR = 6.56, 95% CI (3.54, 12.18)], age 18–24 years [AOR = 4.79, 95% CI (1.72, 13.32)], age 25–34 years [AOR = 1.97, 95% CI (1.01, 3.85)] and being a housewife [AOR = 4.38, 95% CI (1.89, 10.16)] were significant factors associated with dual contraceptive use. The prevalence of dual contraceptive use was low. This shows, there is a need to in promote partner involvement in HIV testing and counseling by offering counseling session in a couple-basis. It is also necessary for programmers to routinely focus on provision of dual contraception for HIV-infected women and Integration of family planning into HIV care follow-up clinic need to be strengthened.
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Affiliation(s)
- Mebratu Mitiku Reta
- Department of Internal Medicine, School of Medicine, University of Gondar, Gondar, Ethiopia.
| | - Gizachew Assefa Tessema
- Department of Reproductive Health, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Getachew Shiferaw
- Department of Gynecology and Obstetrics, School of Medicine, University of Gondar, Gondar, Ethiopia
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13
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Pokharel R, Bhattarai G, Shrestha N, Onta S. Knowledge and utilization of family planning methods among people living with HIV in Kathmandu, Nepal. BMC Health Serv Res 2018; 18:836. [PMID: 30400972 PMCID: PMC6220510 DOI: 10.1186/s12913-018-3643-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 10/23/2018] [Indexed: 11/10/2022] Open
Abstract
Background Addressing family planning (FP) needs of people living with HIV is an effective response to HIV prevention. Healthy timing and spacing of births help ensure the health and well-being of all women and infants, regardless of their HIV-infection. In addition, preventing unintended pregnancies is an important strategy for prevention of mother to child transmission of HIV. The main purpose of this study was to explore the knowledge of family planning methods and identify factors affecting the utilization of such methods among HIV infected men and women attending two Anti-Retroviral Therapy (ART) sites of Kathmandu, Nepal. Methods This was a descriptive cross-sectional study. Two ART sites of Kathmandu were purposively chosen and a sample of 265 respondents (both men and women) was selected based on proportionate probability random sampling. A structured questionnaire was administered face to face to all of the eligible participants. Results The mean ± SD age of the participants was 36.62 ± 7.58 years. Sixty five percent of the respondents’ spouses were HIV positive. A majority of the respondents (72%) had heard of seven modern family planning methods. Considerably high number (72%) of the respondents or their spouses were using at least one of the method of family planning. The most common method was condom (83%) and the least common was IUCD (0.50%). The use of short acting (pills, depo-provera) and long acting (implant, IUCD) family planning methods other than condom dropped from 56.6 to 2% after diagnosis. Utilization of family planning methods was significantly associated with gender, education and HIV status of spouse. Males (Adjusted Odds Ratio (AOR) = 2.48, 95% CI = 1.20–5.07, p = 0.01) educated respondents (AOR = 3.27, 95% CI = 1.41–7.54, p = < 0.01) and individuals whose spouse were not infected with HIV (AOR = 4.70, 95% CI = 1.41–15.67, p = 0.01) were more likely to use FP methods. Conclusion The tendency for HIV infected men and women to avoid additional child bearing in Nepal is higher compared to sub-Saharan Africa. However, the use of effective methods of family planning is low. Therefore, more effective counselling sessions by service providers regarding the availability and use of alternative family planning methods besides condom is necessary.
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Affiliation(s)
- Rajani Pokharel
- Department of Community Medicine and Public Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal.
| | - Geeta Bhattarai
- School of Public Health and Community Medicine, B.P. Koirala Institute of Health Sciences, Ghopa, Dharan, Nepal
| | - Namuna Shrestha
- School of Public Health and Department of Community Medicine, Chitwan Medical College, Bharatpur, Nepal
| | - Sharad Onta
- Department of Community Medicine and Public Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
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14
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Araya BM, Solomon AA, Gebreslasie KZ, Gudayu TW, Anteneh KT. The role of counseling on modern contraceptive utilization among HIV positive women: the case of Northwest Ethiopia. BMC WOMENS HEALTH 2018; 18:121. [PMID: 29973171 PMCID: PMC6033227 DOI: 10.1186/s12905-018-0603-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Accepted: 06/07/2018] [Indexed: 11/23/2022]
Abstract
Background Over 90% of the children with Human Immunodeficiency Virus are infected through the mother to child transmission process according to literatures. Preventing unintended pregnancy by using contraceptive methods is crucial for reducing maternal and child mortality and morbidity. Here we set out to assess the prevalence and associated factors of modern contraceptive utilization among sexually active reproductive age women attending Anti-Retroviral Therapy clinics in Amhara Region referral hospitals in 2016. Methods An institution based cross sectional study was carried out from April to July 2016 surveying women of reproductive age attending the Anti-Retroviral Therapy clinics in the five Amhara Region referral hospitals. A pretested and semi-structured questionnaire was used to collect data. EpiInfo7 and SPSS version 20 soft wares were used for data entry and analysis, respectively. Significant associations were identified on the basis of the adjusted odds ratio, with 95% Confidence Interval, and p value ≤0.05, was taken as statistically significant. Result The proportion of women utilizing modern contraceptives was 47.7% with (95% CI: 43, 52.5%), the male condom being the most (64.2%) utilized method. The use of the contraceptive methods was most prevalent among women 15–24 years of age (AOR = 6.5, 95% CI: 2–10) and age of 25–34 (AOR = 3, 95% CI: 1.6–5.5), having an urban residence (AOR = 0.095, 95% CI: 0.03–0.28), having discussed contraceptives with partner (AOR = 7, 95% CI: 5.3–11.9), receiving counseling from health care providers (AOR = 4.8, 95% CI: 1.8–7), previous history of contraceptive utilization (AOR = 5.6, 95% CI: 2.6–8.3), and with CD4 count >500mm3/dl (AOR = 2.4, 95% CI: 1.3–4.3). Conclusion The proportion of women utilizing contraceptive has been low in Amhara Region referral hospitals. Encouraging patients to discuss about contraception with partners and repeated counseling by health care providers may strengthen contraceptive utilization.
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Affiliation(s)
- Bilen Mekonnen Araya
- School of midwifery, college of medicine and health sciences, university of Gondar, Gondar, Ethiopia.
| | - Abayneh Akililu Solomon
- School of midwifery, college of medicine and health sciences, university of Gondar, Gondar, Ethiopia
| | | | - Temesgen Worku Gudayu
- School of midwifery, college of medicine and health sciences, university of Gondar, Gondar, Ethiopia
| | - Kiber Temesgen Anteneh
- School of midwifery, college of medicine and health sciences, university of Gondar, Gondar, Ethiopia
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15
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Damian DJ, George JM, Martin E, Temba B, Msuya SE. Prevalence and factors influencing modern contraceptive use among HIV-positive women in Kilimanjaro region, northern Tanzania. Contracept Reprod Med 2018; 3:7. [PMID: 29796296 PMCID: PMC5963155 DOI: 10.1186/s40834-018-0060-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Accepted: 04/03/2018] [Indexed: 11/17/2022] Open
Abstract
Background Mother-to-Child-Transmission (MTCT) of HIV is still a public health problem in sub-Saharan Africa. The region has a high unmet need for family planning and high unplanned pregnancy rates among HIV-positive women. Most efforts to prevent MTCT of HIV have focused on the third prong, a strategy which offers antiretroviral (ARV) drugs to HIV-infected pregnant women and their exposed infants. However, the effective use of contraceptives to prevent unplanned pregnancies among women living with HIV is more effective in reducing HIV MTCT. This study aimed at determining the prevalence and factors influencing modern contraceptive use among HIV-positive women in northern Tanzania. Methods This was a cross-sectional study conducted between January and June 2014 in three selected districts of Kilimanjaro region, Tanzania. Data were collected during face-to-face interviews with HIV-positive women attending Care and Treatment Clinics (CTC) in the selected districts. Multivariate logistic regression analysis was used to determine independent predictors of modern contraceptive use. Results In total 672 HIV-positive women were enrolled. Their mean age was 36.4 years (±7.7). Fifty four percent (362) were currently using modern contraceptives, and the most common method used was male condoms 76% (275) followed by Depo-Provera 28% (101). A total of 33% (121) of the users reported dual contraceptive use. Women with primary education [Adjusted Odds Ratio (AOR) = 7.54, 95% Confidence Interval (CI): 1.51–17.48, P = 0.014]; post-secondary [AOR = 6.23, 95% CI: 1.14–14.07, P = 0.035]; not currently on ARVs [AOR = 11.29, 95% CI: 2.60–19.94, P = 0.001]; currently sexually active [AOR = 8.40, 95% CI: 4.47–15.78, P < 0.001]; ever discussed contraceptive use with partner [AOR = 3.68, 95% CI: 1.67–8.11, P = 0.001]; and being counseled on dual contraceptive use at CTC [AOR = 2.94, 95% CI: 1.66–5.23, P < 0.001]; had significantly higher odds of currently using modern contraceptive methods. Conclusions Given the population studied, the prevalence of modern contraceptive use was low. Strategies are required to increase the use of dual and long-term contraceptive methods among women who do not want more children in order to reduce MTCT, and to improve maternal and child health in the region. Programme managers and health care providers need to identify counseling strategies that are specific to HIV-positive women that not only impart knowledge on contraceptives, but also address the issue of responsibility for influencing HIV transmission in the community.
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Affiliation(s)
- Damian J Damian
- 1Department of Community Medicine, Kilimanjaro Christian Medical Centre (KCMC), Moshi, Tanzania.,Department of Epidemiology & Biostatistics, Institute of Public Health, KCMUCo, P. O. Box 2240, Moshi, Tanzania
| | - Johnston M George
- 3Kilimanjaro Christian Medical University College (KCMUCo), Moshi, Tanzania.,Department of Community Health, Institute of Public Health, KCMUCo, Moshi, Tanzania
| | - Erick Martin
- 3Kilimanjaro Christian Medical University College (KCMUCo), Moshi, Tanzania
| | - Beatrice Temba
- 3Kilimanjaro Christian Medical University College (KCMUCo), Moshi, Tanzania
| | - Sia E Msuya
- 1Department of Community Medicine, Kilimanjaro Christian Medical Centre (KCMC), Moshi, Tanzania.,Department of Epidemiology & Biostatistics, Institute of Public Health, KCMUCo, P. O. Box 2240, Moshi, Tanzania.,Department of Community Health, Institute of Public Health, KCMUCo, Moshi, Tanzania
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16
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Mulongo AM, Lihana RW, Githuku J, Gura Z, Karanja S. Factors associated with uptake of dual contraception among HIV-infected women in Bungoma County, Kenya: a cross-sectional study. Pan Afr Med J 2017; 28:2. [PMID: 30167030 PMCID: PMC6113694 DOI: 10.11604/pamj.supp.2017.28.1.9289] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Accepted: 09/26/2016] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION dual contraception, the use of non-barrier contraceptive method in combination with condoms, is an effective strategy in the elimination of mother-to-child transmission (eMTCT) of human immunodeficiency virus (HIV) and the achievement of zero new HIV infections. Despite its effectiveness, dual contraception use among HIV-infected women in Kenya remains low. We identified factors associated with dual contraceptive uptake in Bungoma County, Kenya. METHODS this was a facility-based cross-sectional study in eight hospitals in Bungoma County. We interviewed women using structured questionnaires. We calculated descriptive statistics about the womens' baseline characteristics, examined the association between dual contraceptive use and other factors by calculating Odds Ratios (OR) and 95% Confidence Intervals (CI) and performed logistic regression. RESULTS we recruited 283 HIV-infected women.Among all enrolled women, 190 (67.1%) were aware of dual method and only 109 (38.5%) used dual contraception. The preferred dual pattern was male condom plus injectable contraceptive used by 53.2% of women (58/109). Among the 174 women who did not use dual contraception, 86 (49.4%) preferred using male condoms alone for contraception. Women were more likely to use dual contraception method if they were aware of dual contraception (AOR 12.2, 95% CI 4.7 - 31.7), used non-barrier contraceptives (AOR 9.8 95%; CI 4.5 - 21.3) and had disclosed their HIV status (AOR 7.1 95% CI 2.8 - 18.2) compared to those who did not. CONCLUSION dual contraceptive prevalence was low. Advocacy on dual contraception as an approach to preventing vertical transmission of HIV should be escalated in order to improve its uptake.
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Affiliation(s)
- Agnes Mideva Mulongo
- Jomo Kenyatta University of Agriculture and Technology, Kenya
- Field Epidemiology and Laboratory Training Program, Ministry of Health, Kenya
| | | | - Jane Githuku
- Field Epidemiology and Laboratory Training Program, Ministry of Health, Kenya
| | - Zeinab Gura
- Field Epidemiology and Laboratory Training Program, Ministry of Health, Kenya
| | - Simon Karanja
- Jomo Kenyatta University of Agriculture and Technology, Kenya
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Gebrehiwot SW, Azeze GA, Robles CC, Adinew YM. Utilization of dual contraception method among reproductive age women on antiretroviral therapy in selected public hospitals of Northern Ethiopia. Reprod Health 2017; 14:125. [PMID: 28982364 PMCID: PMC5629799 DOI: 10.1186/s12978-017-0390-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Accepted: 09/26/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Sexually transmitted infections are highly prevalent among pregnant women in Africa. Among the incidence of HIV infection in children, 90% of the infection is attributable to their mothers. Ethiopia is one of the countries with an increasing risky sexual behavior and the most affected by the HIV epidemic. If prevention of mother to child transmission focuses on increasing contraception, it will prevent more than 29% of HIV infection at birth. Therefore, the aim of this study was to assess utilization of dual contraceptive method and associated factors among reproductive age women on antiretroviral therapy in selected public hospitals of Mekelle town, Northern Ethiopia. METHODS Institution based cross-sectional survey was conducted in selected public hospitals of Mekelle among women under antiretroviral therapy from March 1-April 31, 2016. We used a systematic sampling technique to select 331 women. A pretested interviewer administered questionnaire was used for data collection. The data were entered in to Epi data version 3.1 and exported to SPSS version 20 for analysis. Bivariate and multivariable logistic regression analysis was computed. Odds ratio along with 95% CI was computed to ascertain the association. Statistical tests at p-value of < 0.05 were considered as cut off point to determine statistical significance. RESULTS Only 51(15.7%) of participants have utilized dual contraception method. Being single[AOR 5.43, 95% CI (1.61, 18.32)] and cohabitated [AOR 6.06; 95% CI: (2.16, 16.95)] in marital status, having HIV negative partner [AOR 4.44; 95% CI: (1.23, 16.04)], exposure to post diagnosis counseling [AOR 3.03; 95% CI: 1.34, 6.80], disclosed HIV status [AOR 6.06; 95% CI: (1.78, 20.87)] and discussing safer sex with partner [AOR 6.96; 95% CI: (2.75, 16.62)] were positively associated with utilization of dual contraceptive method. CONCLUSION The overall magnitude of dual contraceptive use is still low in this study. This will be a great concern on the transmission of the virus from mother to babies and partners and risk of complications following unintended pregnancy. This will continue to present as major public health problems in the region unless future interventions focuses on the barriers through tailored counseling and husband involvement in all aspects of the HIV/AIDS care.
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Affiliation(s)
| | - Gedion Asnake Azeze
- College of Health Sciences and Medicine, Wolaita Sodo University, Sodo, Ethiopia
| | - Carmen C. Robles
- Department of Midwifery, College of Health Science, Mekelle University, P.O. Box 1871, Mekelle, Ethiopia
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Antelman G, Medley A, Mbatia R, Pals S, Arthur G, Haberlen S, Ackers M, Elul B, Parent J, Rwebembera A, Wanjiku L, Muraguri N, Gweshe J, Mudhune S, Bachanas P. Pregnancy desire and dual method contraceptive use among people living with HIV attending clinical care in Kenya, Namibia and Tanzania. ACTA ACUST UNITED AC 2016; 41:e1. [PMID: 25512359 DOI: 10.1136/jfprhc-2013-100784] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
AIM To describe factors associated with pregnancy desire and dual method use among people living with HIV in clinical care in sub-Saharan Africa. DESIGN Sexually active HIV-positive adults were enrolled in 18 HIV clinics in Kenya, Namibia and Tanzania. Demographic, clinical and reproductive health data were captured by interview and medical record abstraction. Correlates of desiring a pregnancy within the next 6 months, and dual method use [defined as consistent condom use together with a highly effective method of contraception (hormonal, intrauterine device (IUD), permanent)], among those not desiring pregnancy, were identified using logistic regression. RESULTS Among 3375 participants (median age 37 years, 42% male, 64% on antiretroviral treatment), 565 (17%) desired a pregnancy within the next 6 months. Of those with no short-term fertility desire (n=2542), 686 (27%) reported dual method use, 250 (10%) highly effective contraceptive use only, 1332 (52%) condom use only, and 274 (11%) no protection. Respondents were more likely to desire a pregnancy if they were from Namibia and Tanzania, male, had a primary education, were married/cohabitating, and had fewer children. Factors associated with increased likelihood of dual method use included being female, being comfortable asking a partner to use a condom, and communication with a health care provider about family planning. Participants who perceived that their partner wanted a pregnancy were less likely to report dual method use. CONCLUSIONS There was low dual method use and low use of highly effective contraception. Contraceptive protection was predominantly through condom-only use. These findings demonstrate the importance of integrating reproductive health services into routine HIV care.
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Affiliation(s)
- Gretchen Antelman
- Research and Evaluation Director (Tanzania), ICAP, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Amy Medley
- Behavioral Scientist, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Redempta Mbatia
- Executive Director, Tanzania Health Promotion Support, Dar es Salaam, United Republic of Tanzania
| | - Sherri Pals
- Mathematical Statistician, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Gilly Arthur
- Associate Director of Science, CTS Global Inc., assigned to US Centers for Disease Control and Prevention, Dar es Salaam, United Republic of Tanzania
| | - Sabina Haberlen
- Science Office Team Lead, CTS Global Inc., assigned to US Centers for Disease Control and Prevention, Dar es Salaam, United Republic of Tanzania
| | - Marta Ackers
- HIV Care and Treatment Branch Chief, US Centers for Disease Control and Prevention, Nairobi, Kenya
| | - Batya Elul
- Director of Strategic Information (ICAP) and Assistant Professor of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Julie Parent
- Study Coordinator, Ministry of Health and Social Services, Windhoek, Namibia
| | - Anath Rwebembera
- Pediatrician, Ministry of Health and Social Welfare, Dar es Salaam, United Republic of Tanzania
| | - Lucy Wanjiku
- Senior Care and Treatment Medical Officer, US Centers for Disease Control and Prevention, Nairobi, Kenya
| | | | - Justice Gweshe
- Chief Medical Officer and National Programme Manager, Ministry of Health and Social Services, Windhoek, Namibia
| | - Sandra Mudhune
- Senior M&E Officer, Research and Evaluation, The International Center for AIDS Care and Treatment Programs (ICAP), Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Pamela Bachanas
- Behavioral Scientist, US Centers for Disease Control and Prevention, Atlanta, GA, USA
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Munsakul W, Lolekha R, Kowadisaiburana B, Roongpisuthipong A, Jirajariyavej S, Asavapiriyanont S, Hancharoenkit U, Baipluthong B, Pattanasin S, Martin M. Dual contraceptive method use and pregnancy intention among people living with HIV receiving HIV care at six hospitals in Thailand. Reprod Health 2016; 13:8. [PMID: 26842976 PMCID: PMC4739396 DOI: 10.1186/s12978-016-0123-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Accepted: 01/25/2016] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Describe dual contraceptive method use and the intention to become pregnant of people living with HIV (PLHIV) and their partners in Thailand. METHODS From January 2008-March 2009, we systematically selected a cohort of PLHIV from PLHIV seeking care at five tertiary care hospitals and one community hospital to complete a questionnaire assessing sexual activity, intention to become pregnant, and contraceptive practices at baseline and 12 months after enrollment. Participants received short family planning messages every 2-3 months to promote the use of dual contraceptives and were offered family planning services. RESULTS A total of 1,388 PLHIV enrolled, their median age was 37 years (IQR 33-43), 898 (64.7%) had a steady partner, and 737 (53.1%) were male. Among those with a steady partner, 862 (96.0%) did not intend to become pregnant; 709 (82.3%) had sex during the previous 3 months, 683 (96.3%) used at least one contraceptive method, and 202 (29.6%) used dual contraceptive methods. Of the 317 PLHIV who used a single contraceptive method at baseline, 66 (20.8%) reported using dual methods at 12 months. Participants at two tertiary care hospitals where coordinators facilitated PLHIV referral between HIV and OB/GYN clinics were more likely than participants at the other hospitals to change from single method to dual method (p ≤ 0.03). CONCLUSION Few PLHIV in this study intended to become pregnant; however, only one-fourth used dual contraceptive methods. Integrating an assessment of the intention to become pregnant and strengthening the PLHIV referral systems in family planning services may contribute to higher rates of dual contraceptive use.
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Affiliation(s)
- Warangkana Munsakul
- Faculty of Medicine Vajira Hospital, Navamindharadhiraj University, Bangkok, Thailand
| | - Rangsima Lolekha
- Thailand Ministry of Public Health-U.S. Center for Disease Control and Prevention Collaboration, P.O. Box 139, Nonthaburi, 11000 Thailand
| | | | | | | | | | | | - Benjamas Baipluthong
- Thailand Ministry of Public Health-U.S. Center for Disease Control and Prevention Collaboration, P.O. Box 139, Nonthaburi, 11000 Thailand
| | - Sarika Pattanasin
- Thailand Ministry of Public Health-U.S. Center for Disease Control and Prevention Collaboration, P.O. Box 139, Nonthaburi, 11000 Thailand
| | - Michael Martin
- Thailand Ministry of Public Health-U.S. Center for Disease Control and Prevention Collaboration, P.O. Box 139, Nonthaburi, 11000 Thailand
- Division of Global HIV/AIDS, Centers for Disease Control and Prevention, Atlanta, USA
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20
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Joshi B, Velhal G, Chauhan S, Kulkarni R, Begum S, Nandanwar YS, Fonseca M, Baweja S, Turbadkar D, Ramchandran A, Dalal A, Shastri J, Agrawal S, Panhale M, More V, Sanap P, Panchal R, Kanougiya S. Contraceptive Use and Unintended Pregnancies Among HIV-Infected Women in Mumbai. Indian J Community Med 2015; 40:168-73. [PMID: 26170540 PMCID: PMC4478657 DOI: 10.4103/0970-0218.158855] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2014] [Accepted: 11/04/2014] [Indexed: 11/14/2022] Open
Abstract
Background: Access to reproductive health services in Human Immunodeficiency Virus (HIV) programs can greatly enhance program's potential to limit the spread of disease, reduce unintended pregnancies and safeguard the health of infected people. Objectives: To assess (i) knowledge, attitude, and use regarding contraceptives; safe sex and dual protection; (ii) fertility desires and unintended pregnancies post HIV and (iii) symptoms of reproductive tract infection/sexually transmitted infection (RTI/STI) among women infected with HIV. Materials and Methods: A cross-sectional study among 300 currently married HIV-positive women who had not undergone permanent sterilization with no immediate desire for pregnancy. Study site was Integrated Counseling and Testing Centers (ICTC) in tertiary hospitals of Mumbai and women were interviewed using a semistructured questionnaire. Results: In spite of good awareness about modern methods, 42.7 felt that contraceptives other than condoms were harmful to use due to their HIV status. Knowledge on dual protection was limited to condom (75%). Condom use increased from 5.7% pre-HIV to 71.7% post-HIV, with 89.6% reporting regular use. Future fertility desire was expressed by 8.7% women. Induced abortions post-HIV was reported by16.6% women, as pregnancies were unintended. About 69% wished to use dual contraceptive methods for effective protection if it was not harmful to be used by people living with HIV (PLHIV). Conclusion: Data reveals a need to promote modern contraceptive methods along with regular condom use to prevent unintended pregnancies and improve health-seeking behavior for contraception. Health system models that converge or link HIV services with other reproductive health services need to be tested to provide comprehensive reproductive healthcare to infected women in India.
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Affiliation(s)
- Beena Joshi
- Department of Operational Research, National Institute for Research in Reproductive Health, Indian Council of Medical Research, Parel, Mumbai, India
| | - Gajanan Velhal
- Department of Community Medicine, Topiwala National Medical College and Bai Yamunabai Laxman Nair Charitable Hospital, Mumbai, India
| | - Sanjay Chauhan
- Department of Operational Research, National Institute for Research in Reproductive Health, Indian Council of Medical Research, Parel, Mumbai, India
| | - Ragini Kulkarni
- Department of Operational Research, National Institute for Research in Reproductive Health, Indian Council of Medical Research, Parel, Mumbai, India
| | - Shahina Begum
- Department of Operational Research, National Institute for Research in Reproductive Health, Indian Council of Medical Research, Parel, Mumbai, India
| | - Y S Nandanwar
- Department of Obstetrics and Gynaecology, Lokmanya Tilak Municipal Medical College and Sion Hospital, Mumbai, Maharashtra, India
| | - Michelle Fonseca
- Department of Obstetrics and Gynaecology, Lokmanya Tilak Municipal Medical College and Sion Hospital, Mumbai, Maharashtra, India
| | - Sujata Baweja
- Department of Microbiology, Lokmanya Tilak Municipal Medical College and Sion Hospital, Mumbai, Maharashtra, India
| | - Dilip Turbadkar
- Department of Microbiology, Lokmanya Tilak Municipal Medical College and Sion Hospital, Mumbai, Maharashtra, India
| | - Anita Ramchandran
- Department of Microbiology, Lokmanya Tilak Municipal Medical College and Sion Hospital, Mumbai, Maharashtra, India
| | - Asha Dalal
- Department of Obstetrics and Gynaecology, Topiwala National Medical College and Bai Yamunabai Laxman Nair Charitable Hospital, Mumbai, India
| | - Jayanti Shastri
- Department of Microbiology, Topiwala National Medical College and Bai Yamunabai Laxman Nair Charitable Hospital, Mumbai, India
| | - Sachee Agrawal
- Department of Microbiology, Topiwala National Medical College and Bai Yamunabai Laxman Nair Charitable Hospital, Mumbai, India
| | - Manisha Panhale
- Department of Operational Research, National Institute for Research in Reproductive Health, Indian Council of Medical Research, Parel, Mumbai, India
| | - Vasundhara More
- Department of Operational Research, National Institute for Research in Reproductive Health, Indian Council of Medical Research, Parel, Mumbai, India
| | - Pravin Sanap
- Department of Operational Research, National Institute for Research in Reproductive Health, Indian Council of Medical Research, Parel, Mumbai, India
| | - Renuka Panchal
- Department of Operational Research, National Institute for Research in Reproductive Health, Indian Council of Medical Research, Parel, Mumbai, India
| | - Suman Kanougiya
- Department of Operational Research, National Institute for Research in Reproductive Health, Indian Council of Medical Research, Parel, Mumbai, India
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de Camargo CC, Tasca KI, Mendes MB, Miot HA, de Souza LDR. Prevalence of Anogenital Warts in Men with HIV/AIDS and Associated Factors. Open AIDS J 2014; 8:25-30. [PMID: 25317220 PMCID: PMC4195172 DOI: 10.2174/1874613601408010025] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Revised: 07/02/2014] [Accepted: 07/10/2014] [Indexed: 01/08/2023] Open
Abstract
Abstract:
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Affiliation(s)
- Caio Cavassan de Camargo
- Department of Tropical Diseases and Diagnostic Imaging, Botucatu Medical School, Universidade Estadual Paulista - UNESP, Botucatu, São Paulo, Brazil
| | - Karen Ingrid Tasca
- Department of Tropical Diseases and Diagnostic Imaging, Botucatu Medical School, Universidade Estadual Paulista - UNESP, Botucatu, São Paulo, Brazil
| | - Monica Banwart Mendes
- Department of Tropical Diseases and Diagnostic Imaging, Botucatu Medical School, Universidade Estadual Paulista - UNESP, Botucatu, São Paulo, Brazil
| | - Hélio Amante Miot
- Department of Dermatology and Radiology, Botucatu Medical School, Universidade Estadual Paulista - UNESP, Botucatu, São Paulo, Brazil
| | - Lenice do Rosário de Souza
- Department of Tropical Diseases and Diagnostic Imaging, Botucatu Medical School, Universidade Estadual Paulista - UNESP, Botucatu, São Paulo, Brazil
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Ezugwu EC, Nkwo PO, Agu PU, Ugwu EO, Asogwa AO. Contraceptive use among HIV-positive women in Enugu, southeast Nigeria. Int J Gynaecol Obstet 2014; 126:14-7. [DOI: 10.1016/j.ijgo.2013.12.014] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2013] [Revised: 12/17/2013] [Accepted: 03/13/2014] [Indexed: 10/25/2022]
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Abstract
PURPOSE OF REVIEW We reviewed recent literature on the role of family planning in eliminating new pediatric HIV infections. RECENT FINDINGS Global commitments to eliminate new pediatric HIV infections recognize that preventing unintended pregnancies among women with HIV is essential to achieving this goal. However, substantial shortcomings exist in translating this policy support into widespread practice. Programs to prevent mother-to-child transmission of HIV continue to be implemented and evaluated as a narrow set of interventions that typically begins in antenatal care, after a woman is already pregnant. In addition, data suggest that women living with HIV experience high rates of unmet need for family planning and unintended pregnancies. Evidence is growing that integrating family planning and HIV services is an effective strategy for increasing access to contraception among women with HIV who do not wish to become pregnant. A number of health system obstacles must be resolved to achieve effective, sustained delivery of integrated services at scale. SUMMARY Prevention of unintended pregnancies among women with HIV must be elevated as a programmatic priority. By strengthening family planning programs for all women, and better integrating family planning and HIV services, progress toward ending new pediatric HIV infections will be accelerated.
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Mishra SR, Joshi MP, Khanal V. Family planning knowledge and practice among people living with HIV in Nepal. PLoS One 2014; 9:e88663. [PMID: 24551132 PMCID: PMC3923813 DOI: 10.1371/journal.pone.0088663] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2013] [Accepted: 01/14/2014] [Indexed: 11/23/2022] Open
Abstract
Unsafe sexual behavior is common among the HIV infected. This exposes them to the risks of unintended pregnancy, HIV transmission to uninfected partners and super-infection. Studies on the use of family planning measures among People Living with HIV (PLHIV) are scarce in Nepal. The aim of this study was to explore the knowledge and practice of family planning (FP) in PLHIV. A cross sectional survey was conducted during July-December 2012 in Kaski district of Nepal. A total of 120 PLHIVs were recruited using snowball sampling from three HIV clinics within the Pokhara sub-metropolitan city area. This study found that nine in ten PLHIV had heard about family planning. Two thirds of respondents were using at least one FP method. The majority (65.8%) used condoms and had received FP counseling (67.5%). Less than one percent used condoms in addition to another contraceptive. Being single, being female and having received the counselling sessions were associated with the use of FP. The individuals who received FP counseling were more likely [OR 4.522; 95% CI (1.410-14.504)] to use FP. Females were more likely [OR 4.808; 95% CI (1.396-16.556)] to use FP than males. The individuals who were single/de-facto widowed were more likely [OR 7.330; 95% CI (2.064-26.028)] to use FP than the married individuals. Our findings suggest that there is a need to focus on FP counseling if the HIV prevention program is to increase FP use among the PLHIV population. Use of dual contraceptives need to be promoted through counseling sessions and other health promotion programs focusing in HIV prevention.
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Affiliation(s)
- Shiva Raj Mishra
- Institute of Medicine, Maharajgunj Medical Campus, Kathmandu, Nepal
| | | | - Vishnu Khanal
- Curtin University, School of Public Health, Perth, Australia
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Kendall T. Falling short of universal access to reproductive health: unintended pregnancy and contraceptive use among Mexican women with HIV. CULTURE, HEALTH & SEXUALITY 2013; 15 Suppl 2:S166-S179. [PMID: 23782295 DOI: 10.1080/13691058.2013.798685] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
A favourable context for women with HIV to prevent unintended pregnancy is a cornerstone of reproductive rights and will contribute to achieving universal access to reproductive health, a Millennium Development Goal target. This analysis explores the reproductive trajectories of Mexican women with HIV post-diagnosis and their access to reproductive counselling and use of contraceptives. In-depth interviews and short surveys were conducted with women of reproductive age living with HIV. Results indicate that sexual and reproductive health counselling in HIV care focuses on the male condom and does not routinely address reproductive desires or provide information about or access to other contraceptive methods. Unintended pregnancies result from inconsistent condom use and condom breakage. Women experienced discriminatory denial of and pressure to accept particular contraceptive methods because of their HIV status. Mexican women with HIV are not enjoying their constitutionally guaranteed right to freely choose the number and spacing of their children. Mexico's commitment to reproductive rights and the Popular Health Insurance offer policy and financial frameworks for providing family planning services in public HIV clinics. To ensure respectful implementation, rights-based training for HIV healthcare providers and careful monitoring and evaluation will be needed.
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Affiliation(s)
- Tamil Kendall
- Women and Health Initiative, Department of Global Health and Population, Harvard School of Public Health, Boston, MA, USA.
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Meeting the Contraceptive Needs of Key Populations Affected by HIV in Asia: An Unfinished Agenda. AIDS Res Treat 2012; 2012:792649. [PMID: 22991656 PMCID: PMC3443984 DOI: 10.1155/2012/792649] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2012] [Revised: 08/10/2012] [Accepted: 08/13/2012] [Indexed: 11/24/2022] Open
Abstract
Like all women, women living with and at risk of acquiring HIV have the right to determine the number and timing of their pregnancies and to safely achieve their reproductive intentions. Yet, many women in Asia affected by HIV lack access to family planning services and experience disproportionately high rates of unintended pregnancy and abortion. Programs that have succeeded in promoting condom use and providing HIV prevention and treatment services in this region have largely missed the opportunity to address the contraceptive needs of the key populations they serve. The importance of better linkages between family planning and HIV policies and programs is now widely recognized by global health policymakers and donors. However, to date, most of the efforts to improve these linkages have been conducted in Africa. Greater attention is needed to the developing, implementing, and evaluating of integrated family planning/HIV approaches that are tailored to the political, cultural, and public health context in Asia. In this paper, we describe the use of and need for family planning among key populations affected by HIV in Asia, discuss the challenges to effectively addressing of these needs, and offer recommendations for strengthening the linkages between family planning and HIV policies and programs in the region.
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