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Assefa S, Dheresa M, Lami M, Berhanu B, Mohammed H, Sertsu A, Negash A, Balcha T, Eyeberu A, Debella A, Getachew T, Yadeta TA. Fertility desires of antiretroviral therapy-attending HIV-positive women and its associated factors in Harari region, Ethiopia. Int Health 2024; 16:174-181. [PMID: 37128936 PMCID: PMC10911533 DOI: 10.1093/inthealth/ihad030] [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: 01/26/2023] [Revised: 03/01/2023] [Accepted: 04/05/2023] [Indexed: 05/03/2023] Open
Abstract
BACKGROUND The desire to have children among mothers living with HIV remains a serious public health issue in nations with low coverage for antiretroviral therapy and the prevention of mother-to-child transmission, even if it is feasible to have an HIV-negative child. Therefore, this study aimed to assess fertility desire and associated factors among antiretroviral therapy-attending HIV-positive women at Hiwot Fana Specialized University Hospital, in Harari, Ethiopia. METHODS A facility-based cross-sectional study design was employed among 639 anti retro-viral therapy attending HIV - positive women by systematic random sampling method selected from June 15 to November 30, 2020. A binary logistic regression model was fitted to identify the associated factors with fertility desire. Descriptive results were presented in percentages, whereas analytical results were reported in adjusted ORs (AORs) with a 95% CI. At p=0.05, statistical significance was declared. RESULTS A total of 639 participants were included in the study; 69.5%(95% CI 65.7 to 72.9%) of the participants had fertility desire. Younger age (<35 years) (AOR=2.35, 95% CI 1.27 to 4.35), married women (AOR=3.02, 95% CI 1.32 to 12.25), childless women (AOR=2.86, 95% CI 1.17 to 4.82) and women whose duration of HIV diagnosis was ≤5 years (AOR=0.41, 95% CI 0.20 to 0.71) were significantly associated with fertility desire. CONCLUSION The majority of the study participants have a desire to have children. In light of the high prevalence of fertility desire among antiretroviral therapy-attending HIV-positive women, it is recommended to counsel younger women on reproductive planning and encourage partner testing.
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Affiliation(s)
- Sirgut Assefa
- Higher clinic, P.O. box: 235, Haramaya University, Harar town, Harari, Ethiopia
| | - Merga Dheresa
- Department of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar town, Harari 3200, Ethiopia
| | - Magarsa Lami
- Department of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar town, Harari 3200, Ethiopia
| | - Bekelu Berhanu
- Department of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar town, Harari 3200, Ethiopia
| | - Hanan Mohammed
- Department of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar town, Harari 3200, Ethiopia
| | - Addisu Sertsu
- Department of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar town, Harari 3200, Ethiopia
| | - Abraham Negash
- Department of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar town, Harari 3200, Ethiopia
| | - Tegenu Balcha
- Department of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar town, Harari 3200, Ethiopia
| | - Addis Eyeberu
- Department of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar town, Harari 3200, Ethiopia
| | - Adera Debella
- Department of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar town, Harari 3200, Ethiopia
| | - Tamirat Getachew
- Department of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar town, Harari 3200, Ethiopia
| | - Tesfaye Assebe Yadeta
- Department of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar town, Harari 3200, Ethiopia
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Tufa D, Wassihun B, Misker D, Beyene K. Fertility desire and associated factors among women of reproductive age living with HIV/AIDS attending antiretroviral therapy clinic in Arba Minch General Hospital, South Ethiopia, 2021. Front Glob Womens Health 2023; 4:1001479. [PMID: 38025980 PMCID: PMC10666766 DOI: 10.3389/fgwh.2023.1001479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Accepted: 09/18/2023] [Indexed: 12/01/2023] Open
Abstract
Background The fertility desire of women living with HIV to have children can have significant implications for public health. Despite the increase in the number of HIV-positive women, the issues of their fertility desire have not been well-studied. This study aims to assess fertility desire and associated factors among women living with HIV/AIDS. Methods A facility-based cross-sectional study was conducted from 1 May to 30 July 2021. The researchers employed a systematic sampling technique. The data were gathered and entered into EpiData 3.1 software, and subsequently exported to the statistical package for social science version 25 for analysis. Binary logistic regression analyses were used to identify the factors involved, and a p-value of <0.05 at a 95% confidence level was deemed to be statistically significant. Result The findings of this study indicate that 47.8% of women expressed a desire to conceive. Various factors such as parents' pressure [adjusted odds ratio (AOR) = 4.41, 95% confidence interval (CI): 2.15-9.05], community pressure (AOR = 2.62, 95% CI: 1.30-5.26), being married (AOR = 0.25, 95% CI: 0.09-0.73), having only female offspring (AOR = 2.57, 95% CI: 1.12-5.90), and having HIV seropositive children (AOR = 2.45, 95% CI: 1.23-4.85) had statistically significant association with fertility desire. Conclusion The study area exhibited a high level of fertility desire. Various factors can influence fertility desire, including parents' pressure, community pressure, being married, having only female offspring, and having children who are HIV seropositive. When developing interventions on sexual and reproductive health issues, it is imperative for policymakers and healthcare providers who are working in antiretroviral therapy clinics to take into account the effects of these factors on women living with HIV. When designing and implementing prevention of mother-to-child transmission services, it is important to consider the fertility desires of mothers who are living with HIV.
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Affiliation(s)
- Disasa Tufa
- Gather Hospital, South Omo Zone, Jinka, Ethiopia
| | - Biresaw Wassihun
- Department of Midwifery, College of Health Sciences, Injibara University, Injibara, Ethiopia
| | - Direslgne Misker
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Kassaw Beyene
- Department of Midwifery, College of Health Sciences, Arba Minch University, Arba Minch, Ethiopia
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Bernard C, Hassan SA, Humphrey J, Thorne J, Maina M, Jakait B, Brown E, Yongo N, Kerich C, Changwony S, Qian SRW, Scallon AJ, Komanapalli SA, Enane LA, Oyaro P, Abuogi LL, Wools-Kaloustian K, Patel RC. Impacts of the COVID-19 pandemic on access to HIV and reproductive health care among women living with HIV (WLHIV) in Western Kenya: A mixed methods analysis. Front Glob Womens Health 2022; 3:943641. [PMID: 36578364 PMCID: PMC9790904 DOI: 10.3389/fgwh.2022.943641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Accepted: 11/18/2022] [Indexed: 12/14/2022] Open
Abstract
Introduction The COVID-19 pandemic has impacted access to health services. Our objective was to understand the pandemic's impact on access to HIV, pregnancy, and family planning (FP) care among women living with HIV (WLHIV). Methods Data were collected after June 2020, when questions about the pandemic were added to two ongoing mixed methods studies using telephone surveys and in-depth interviews among WLHIV in western Kenya. The Chaguo Langu (CL) study includes primarily non-pregnant WLHIV receiving HIV care at 55 facilities supported by AMPATH and the Opt4Mamas study includes pregnant WLHIV receiving antenatal care at five facilities supported by FACES. Our outcomes were self-reported increased difficulty refilling medication, accessing care, and managing FP during the pandemic. We summarized descriptive data and utilized multivariable logistic regression to evaluate predictors of difficulty refilling medication and accessing care. We qualitatively analyzed the interviews using inductive coding with thematic analysis. Results We analyzed 1,402 surveys and 15 in-depth interviews. Many (32%) CL participants reported greater difficulty refilling medications and a minority (14%) reported greater difficulty accessing HIV care during the pandemic. Most (99%) Opt4Mamas participants reported no difficulty refilling medications or accessing HIV/pregnancy care. Among the CL participants, older women were less likely (aOR = 0.95, 95% CI: 0.92-0.98) and women with more children were more likely (aOR = 1.13, 95% CI: 1.00-1.28) to report difficulty refilling medications. Only 2% of CL participants reported greater difficulty managing FP and most (95%) reported no change in likelihood of using FP or desire to get pregnant. Qualitative analysis revealed three major themes: (1) adverse organizational/economic implications of the pandemic, (2) increased importance of pregnancy prevention during the pandemic, and (3) fear of contracting COVID-19. Discussion The two unique participant groups included in our study encountered overlapping problems during the COVID-19 epidemic. Access to HIV services and antiretrovirals was interrupted for a large proportion of non-pregnant WLHIV in western Kenya, but access to pregnancy/family planning care was less affected in our cohort. Innovative solutions are needed to ensure HIV and reproductive health outcomes do not worsen during the ongoing pandemic.
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Affiliation(s)
- Caitlin Bernard
- Department of Obstetrics and Gynecology, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Shukri A. Hassan
- Department of Medicine, University of Washington, Seattle, WA, United States
| | - John Humphrey
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Julie Thorne
- Department of Obstetrics and Gynecology, University of Toronto, Toronto, ON, Canada
| | - Mercy Maina
- Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya
| | - Beatrice Jakait
- Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya
| | | | | | - Caroline Kerich
- Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya
| | - Sammy Changwony
- Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya
| | - Shirley Ru W. Qian
- Department of Public Health, University of Washington, Seattle, WA, United States
| | - Andrea J. Scallon
- Jackson School of International Studies, University of Washington, Seattle, WA, United States
| | | | - Leslie A Enane
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, United States
| | | | - Lisa L. Abuogi
- Department of Pediatrics, University of Colorado, Denver, CO, United States
| | - Kara Wools-Kaloustian
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Rena C. Patel
- Department of Medicine, University of Washington, Seattle, WA, United States
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Bernard C, Jakait B, Fadel WF, Mocello AR, Onono MA, Bukusi EA, Wools-Kaloustian KK, Cohen CR, Patel RC. Preferences for Multipurpose Technology and Non-oral Methods of Antiretroviral Therapy Among Women Living With HIV in Western Kenya: A Survey Study. Front Glob Womens Health 2022; 3:869623. [PMID: 35663925 PMCID: PMC9160913 DOI: 10.3389/fgwh.2022.869623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 04/27/2022] [Indexed: 11/17/2022] Open
Abstract
Introduction Understanding interests in and preferences for multipurpose technology (MPT) for the co-administration of contraception and antiretroviral therapy (ART) and alternative, non-oral ART methods among women living with HIV (WLHIV) is vital to successful implementation of future treatment options, such as long-acting injectable ART. Methods Between May 2016 and March 2017 we conducted a cross-sectional telephone survey of 1,132 WLHIV of reproductive potential with prior experience using intermediate- or long-acting contraceptive methods in western Kenya. We present descriptive statistics and multinomial logistic regression to evaluate predictors of interest in specific MPT and non-oral ART methods. Results Two-thirds (67%) reported interest in MPT, with the most common reason for interest being ease of using a single medication for both purposes of HIV treatment and pregnancy prevention (26%). Main reasons for lack of interest in MPT were need to stop/not use contraception while continuing ART (21%) and risk of side effects (16%). Important characteristics of MPT were effectiveness for pregnancy prevention (26%) and HIV treatment (24%) and less than daily dosing (19%). Important characteristics of non-oral ART methods were less than daily dosing (47%), saving time accessing ART (16%), and effectiveness of HIV treatment (15%). The leading preferred methods for both MPT and non-oral ART were injectables (50 and 54%) and implants (32 and 31%). Prior use of a contraceptive implant or injectable predicted interest in similar methods for both MPT and non-oral ART methods, while this relationship did not appear to vary between younger vs. older WLHIV. Discussion Most WLHIV in western Kenya are interested in MPT for HIV treatment and contraception. Prior exposure to contraceptive implants or injectables appears to predict interest in similar methods of MPT and non-oral ART. Developers of MPT and non-oral ART methods should strongly consider WLHIV's preferences, including their changing reproductive desires.
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Affiliation(s)
- Caitlin Bernard
- Department of Obstetrics & Gynecology, Division of Family Planning, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Beatrice Jakait
- Moi Teaching & Referral Hospital/Moi University & Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya
| | - William F. Fadel
- Department of Biostatistics, Indiana University School of Medicine, Indianapolis, IN, United States
| | - A. Rain Mocello
- Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology & Reproductive Health, University of California San Francisco, CA, United States
| | - Maricianah A. Onono
- Centre for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - Elizabeth A. Bukusi
- Centre for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya
| | | | - Craig R. Cohen
- Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology & Reproductive Health, University of California San Francisco, CA, United States
| | - Rena C. Patel
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, WA, United States
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Akinyemi JO, Afolabi RF, Awolude OA, Afolabi Bamgboye E. Demography of remarriage and fertility desire among women receiving antiretroviral therapy in South West Nigeria. AJAR-AFRICAN JOURNAL OF AIDS RESEARCH 2021; 20:15-24. [PMID: 33632069 DOI: 10.2989/16085906.2020.1853187] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background: In view of sociocultural norms surrounding marriage and childbearing in South West Nigeria, fertility desire may be stronger among remarried women living with HIV. This article describes the characteristics of remarriage and its relationship to fertility desire.Method: A cross-sectional study was conducted among HIV-positive women aged 18-49 years at the Antiretroviral Treatment (ART) clinic, College of Medicine/University College Hospital, Ibadan, Nigeria between November and December 2015. Data were analysed using descriptive statistics and generalised linear models.Results: Overall, 123 (17.3%) of 711 women had experienced remarriage. Significant factors among remarried women were a lack of formal education (ORadj = 3.35, CI: 1.46-7.72); polygamous family (ORadj = 2.65, CI: 1.71-4.12), and serodiscordant union (ORadj = 1.97, CI: 1.14-3.41). Fertility desire was expressed by 410 women (57.7%). After controlling for demographic, socio-economic, and HIV-care characteristics, remarried women were 2.5 times as likely to have fertility desire compared to their counterparts who never remarried (ORadj = 2.49, CI: 1.43-4.33). Younger age was significantly associated with higher odds of fertility desire. Other factors negatively associated with fertility desire were education (ORadj = 0.30, CI: 0.12-0.74) and number of surviving children (ORadj = 0.28, CI: 0.22-0.34).Conclusion: HIV-care and treatment programmes need to pay attention to reproductive concerns, especially among women in second and higher order marriages.
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Affiliation(s)
- Joshua O Akinyemi
- Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria.,Demography and Population Studies, Schools of Public Health and Social Sciences, University of the Witwatersrand, Johannesburg, South Africa.,Infectious Disease Institute, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Rotimi F Afolabi
- Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Olutosin A Awolude
- Infectious Disease Institute, College of Medicine, University of Ibadan, Ibadan, Nigeria.,Department of Obstetrics and Gynaecology, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - E Afolabi Bamgboye
- Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria
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Chirambira P, Madiba S, Ntuli B. Societal and individual drivers of fertility desires and intentions among people living with HIV: a cross sectional study of HIV clinic attendees in Soweto, South Africa. AIMS Public Health 2021; 9:173-184. [PMID: 35071676 PMCID: PMC8755963 DOI: 10.3934/publichealth.2022013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 11/30/2021] [Indexed: 11/18/2022] Open
Abstract
Background High proportion of people living with HIV (PLHIV) who are in the prime of their reproductive years desire to have children. There are limited studies that explore the range of fertility intentions for PLHIV. This study investigated the fertility desires and intentions of PLHIV and the associated factors. Methods This was a cross-sectional study of 442 PLHIV receiving antiretroviral treatment (ART) in health facilities in Soweto, an urban township that is situated in the City of Johannesburg in South Africa. STATA version 13 was used to analyze the data. Results The participants' mean age was 36.3 years, 70% were females, 79.6% had at least one biological child, and 36% had 3+ children. Almost half (47%) expressed the desire for children, saying that this was because they had no biological children, or their partners wanted children, or they wanted children of a particular sex, or were feeling healthy after taking ART. An increased fertility desire was associated with absence of biological children (AOR = 5.06, 95% CI: 2.11–12.1) and with being married (AOR = 2.63, 95% CI: 1.31–5.27). A decreased fertility desire was associated with being aged 36+ (AOR = 2.63, 95% CI: 1.31–5.27), having primary education (AOR = 0.11, 95% CI: 0.01–1.30) and having ≥4 years of ART duration (AOR = 0.45, 95% CI: 0.24–0.81). Conclusion Individual factors played a significant role in shaping the fertility desires of PLHIV in this setting. The high desire for children underscore the need to integrate reproductive health services in HIV and AIDS care and treatment services and develop safer conception programmes to help PLHIV to conceive and have children safely.
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Mosisa G, Tsegaye R, Wakuma B, Mulisa D, Etefa W, Abadiga M, Fekadu G, Oluma A, Turi E. Fertility desire and associated factors among people living with HIV in Ethiopia: a systematic review and meta-analysis. ACTA ACUST UNITED AC 2020; 78:123. [PMID: 33292626 PMCID: PMC7685622 DOI: 10.1186/s13690-020-00504-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 11/05/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND Increased Anti-Retroviral Therapy (ART) coverage improves health status and the survival of people living with Human Immunodeficiency Virus (HIV) as a result, reproductive health needs of the clients are increased. As part of continuum HIV care, understanding fertility desire and reproductive health care needs of HIV positive peoples will play paramount role in planning and delivering appropriate health services. The finding of studies conducted on the fertility desire and associated factors among People Living with HIV in Ethiopia presented inconclusive. Therefore, this study aimed to assess the pooled prevalence of fertility desire and associated factors among people living with HIV in Ethiopia. METHODS A total of 26 studies conducted in Ethiopia were included in this Meta-analysis. Pub Med, HINARI, Google scholar and Google data bases were searched. Data from the included articles were extracted using a standardized data extraction tool. The included studies were analyzed using a random effects meta-analysis model. Analysis was done Using STATA version 14 statistical software. Heterogeneity was assessed statistically using the standard Chi-square, I2. The association between fertility desire and factors were examined using a random effects model. RESULT In this meta-analysis, the pooled prevalence of fertility desire in Ethiopia is 42.21% (95%CI 39.18, 45.25). Fertility desire is significantly associated with sex: being female (OR = 0.71,95%CI 0.57,0.86), partners desire (OR = 16.8, 95% CI: 9.45, 29.88), not having child (OR = 5.46 95%CI 4.24, 7.040), age < 30(OR = 2.34, 95%CI 2.10, 2.60), formal education (OR = 1.31 95%CI 1.09, 1.59)). However, use of family planning, residence, and Knowledge on Prevention of Mother to Child Transmission and disclosure status didn't show association with fertility desire. CONCLUSION In this finding, significant people of living with HIV have a desire to have a child. The finding showed the need to strengthen fertility desire and reproductive health care needs of HIV positive peoples. Therefore, strengthening the integration of fertility related issues with HIV continuum care will play a paramount role in averting risky sexual behaviors and Prevention of Mother to Child Transmission among peoples on ART.
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Affiliation(s)
- Getu Mosisa
- School of Nursing and Midwifery, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia.
| | - Reta Tsegaye
- School of Nursing and Midwifery, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Bizuneh Wakuma
- School of Nursing and Midwifery, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Diriba Mulisa
- School of Nursing and Midwifery, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Werku Etefa
- School of Nursing and Midwifery, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Muktar Abadiga
- School of Nursing and Midwifery, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Ginenus Fekadu
- Department of Pharmacy, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Adugna Oluma
- School of Nursing and Midwifery, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Ebisa Turi
- Department of Public health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
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Balis B. Risky Sexual Practice and Associated Factors Among Women Living with HIV/AIDS Receiving Antiretroviral Therapy at a PMTCT Clinic in Western Oromia, Ethiopia. HIV AIDS-RESEARCH AND PALLIATIVE CARE 2020; 12:739-747. [PMID: 33235515 PMCID: PMC7678463 DOI: 10.2147/hiv.s258740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 10/21/2020] [Indexed: 11/23/2022]
Abstract
Background Human immunodeficiency virus infection has been one of the top health-related challenges for the past four decades. Ethiopia is extremely infected by HIV pandemic every year, whereby 22,300 people were newly infected and 690,000 were living with HIV at the end of 2018. Sexual behavior of HIV positive individuals visiting treatment clinics is a neglected issue. Nonetheless, it has been a significant way of HIV transmission to serodiscordant partners. Methods A facility-based cross-sectional study design was used on a sample of 432 women attending treatment clinics in west Oromia from February 26 to March 26, 2019. Systematic sampling was used to select the study participants. A pretested and structured interviewer-administered questionnaires were used to collect the data. The data were coded, entered, cleaned and exported to SPSS version 20.0 for analysis. Descriptive statistics were used to present frequency distributions. Variables with P-value <0.25 during bivariate analysis were entered into multiple logistic regression models to control for all possible confounders. Odds ratio along with 95% CI were estimated to measure the strength of the association. Level of statistical significance was declared at a p-value less than 0.05. Results Out of total respondents, 240 (56.9%), 95% CI: (52.1–61.6%) were involved in risky sexual practices in the prior 12 months. Urban residence [AOR: 3.24, (95% CI: (1.52, 6.89)], those with no formal education [AOR: 2.77, (95% CI: (1.18, 6.54)], being on ART for >2years [AOR: 2.74, (95% CI: (1.13, 6.65)] and CD4 count ≥200 cells/mm3 [AOR: 3.20, (95% CI: (1.50, 6.82)] were factors significantly associated with risky sexual practice. Conclusion A considerable number of respondents were involved in risky sexual practices 240 (56.9%) due to being rural residence, not attending formal education, being on ART for >2 years and CD4 count ≥200 cells/mm3.
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Affiliation(s)
- Bikila Balis
- Department of Midwifery, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Western Oromia, Ethiopia
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Dadabhai S, Makanani B, Hua N, Kawalazira R, Taulo F, Gadama L, Taha TE. Resumption of postpartum sexual activity and menses among HIV-infected women on lifelong antiretroviral treatment compared to HIV-uninfected women in Africa. Int J Gynaecol Obstet 2020; 149:211-218. [PMID: 32037538 DOI: 10.1002/ijgo.13113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 11/11/2019] [Accepted: 02/06/2020] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To determine time from delivery to resumption of sexual activity and menses among HIV-infected women on antiretroviral treatment (ART) and HIV-uninfected women. METHODS HIV-infected women on ART and HIV-uninfected women were recruited from five health facilities at delivery and followed prospectively for a maximum of 1 year in Blantyre, Malawi from January 2016 to September 2017. Sociodemographic, clinical, and laboratory data were collected at delivery and 1.5, 3, 6, 9, and 12 months. Descriptive, time to event Kaplan-Meier, and multivariable Cox proportional hazards analyses were conducted. RESULTS Data on 878 women (460 [52.4%] HIV-uninfected and 418 [47.6%] HIV-infected, P=0.156) who attended at least one follow-up visit were analyzed. Among HIV-uninfected compared to HIV-infected women, respectively, the median number of days to resumption of sexual activity was 180 vs 181; to irregular menses was 82 vs 71; and to regular menses was 245 vs 366. In multivariable models, being married was associated with early resumption of sexual activity (hazard ratio [HR] 1.91, P<0.001), and being HIV-infected and use of an effective method of family planning were associated with later start of regular menses (HR<1.0, P<0.050). CONCLUSION Counseling of women on reproductive intentions should start early irrespective of HIV infection or use of ART.
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Affiliation(s)
- Sufia Dadabhai
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Bonus Makanani
- Department of Obstetrics and Gynecology, College of Medicine, University of Malawi, Blantyre, Malawi
| | - Nan Hua
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Rachel Kawalazira
- College of Medicine-Johns Hopkins Research Project, Blantyre, Malawi
| | - Frank Taulo
- Department of Obstetrics and Gynecology, College of Medicine, University of Malawi, Blantyre, Malawi
| | - Luis Gadama
- Department of Obstetrics and Gynecology, College of Medicine, University of Malawi, Blantyre, Malawi
| | - Taha E Taha
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
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