The aim of this study was to determine men’s perceptions about family planning and how they participate or wish to participate in family planning activities in Mpigi District, central Uganda. Four focus group discussions were conducted with married men and with family planning providers from both the government and private sector. In addition, seven key informants were interviewed using a semi-structured interview guide. The results indicate that men have limited knowledge about family planning, that family planning services do not adequately meet the needs of men, and that spousal communication about family planning issues is generally poor. However, almost all men approved of modern family planning and expressed great interest in participating. The positive change of the beliefs and attitudes of men towards family planning in the past years has not been recognized by family planning programme managers, since available services are not in line with current public attitudes. A more couple-oriented approach to family planning is needed. Measures could include, for example, recruiting males as family planning providers, offering more family planning counselling for couples, and promoting female-oriented methods with men and vice versa.

BackgroundInternet access via mobile phones and computers facilitates interaction and potential health communication among individuals through social networking. Many South African adolescents own mobile phones and can access social networks via apps.ObjectiveWe investigated sociodemographic factors and HIV risk behaviors of adolescent social networking users in Soweto, South Africa.MethodsWe conducted an interviewer-administered, cross-sectional survey of adolescents aged 14-19 years. Independent covariates of social networking were assessed by multivariate logistic regression analysis.ResultsOf 830 adolescents, 57% (475/830) were females and the median age was found to be 18 years (interquartile range 17-18). Social networking was used by 60% of adolescents (494/830); more than half, that is, 87% (396/494) accessed social networks through mobile phones and 56% (275/494) spent more than 4 hours per day using their mobile phones. Social networking was independently associated with mobile usage 2-4 hours (adjusted odds ratio [AOR]: 3.06, CI: 1.69-5.51) and more than 4 hours per day (AOR: 6.16, CI: 3.46-10.9) and one (AOR: 3.35, CI: 1.79-6.27) or more sexual partner(s) (AOR: 2.58, CI: 1.05-6.36).ConclusionsMobile phone–based social networking is prevalent among sexually active adolescents living in Soweto and may be used as an entry point for health promotion and initiation of low-cost adolescent health interventions.

The recognition of key demographic and behavioral characteristics can help focus interventions for patients at higher risk of gonorrhea reinfection.

BackgroundPrevention of unplanned pregnancy is critical for women living with HIV (WLWH) to safely achieve their reproductive goals, and forms the second prong of the Global Plan to eliminate perinatal transmission of HIV. Family planning services need to identify women at risk of unplanned pregnancy to be effective. This study examines the relationship between unplanned pregnancy and subsequent use of effective contraception among WLWH in Uganda.MethodsThis is a retrospective analysis of data from the Uganda Aids Rural Treatment Outcomes study, which was a longitudinal cohort of individuals initiating antiretroviral therapy. Women with incident pregnancies between 2011 and 2013 who reported on intent of the pregnancy were included in this analysis. The exposure of interest was referent pregnancy intent, using questions derived from the CDC PRAMS instrument. The primary outcome was self-report of effective contraceptive use 9–15 months post-partum (hormonal methods, intrauterine device, sterilization, or consistent condom use).ResultsAmong 455 women who enrolled with a baseline median age of 29 years, CD4 count 403 cells/mm3, and living with HIV for 3.8 years, there were 110 incident pregnancies with reported intent. Of these pregnancies, 50 (45%) were reported as unplanned, and 60 (55%) as planned. Postpartum, 51% of women with unplanned and 44% with planned pregnancy reported effective contraception (P = 0.52). In models adjusted for pregnancy intent, only partner pregnancy desire was significantly associated with contraceptive use, with aRR 0.37 (95% CI 0.18–0.76, P = 0.01) for effective contraceptive use when the participant reported that her primary partner “definitely or probably” wants her to have a child compared with “never discussed or don’t know”.ConclusionAlmost half of incident pregnancies among WLHW in this cohort were unplanned. Unplanned pregnancy was not associated with effective contraceptive use post-partum. These results demonstrate continued unmet need for family planning services in this population. Creative strategies to support the planning of families among women living with HIV are needed. Engaging men is likely to be a critical approach.Disclosures J. E. Haberer, Merck: Consultant, Consulting fee; Natera: Shareholder, Stock ownership

Background High rates of adolescent pregnancies in South Africa continues to be a pressing public health concern. This study examines (1) the prevalence of current contraceptive use; and (2) the independent association between adolescent pregnancy and effective contraception use. Methods This study uses baseline cross-sectional data from a youth-centered sexual and reproductive health (SRH) cohort study among youth (aged 16–24) in Soweto and Durban (2011–2017). Among 207/253 females reporting consensual sexual activity, crude and adjusted logistic regression examine associations between ever having an adolescent pregnancy (aged 15–19) or pregnancy at age 20–24 (ref no pregnancy) and effective contraception use (barrier and/or hormonal methods) in the last 6 months. Results Over one-third (34.3%, n = 71) of females reported a history of adolescent pregnancy and 13.0% (n = 27) had a pregnancy at age 20–24. Nearly all (95.9%, n = 94) first pregnancies were unintentional. Current effective contraceptive use was reported by 74.6% (n = 53) with an adolescent pregnancy, 66.6% (n = 18) of those pregnant at 20–24 years, and 46.8% (n = 51) of never pregnant females (p < 0.001). All effective contraceptive users pregnant at 20–24 years and 83% (n = 44) of the adolescent pregnancy group reported using hormonal methods vs. 52.9% (n = 27) of never pregnant females. In the adjusted model, a history of adolescent pregnancy was associated with 3.45 (95%CI = 1.75–6.82) times greater odds of effective contraceptive use (vs. no pregnancy). Conclusion suggest that adolescent females are accessing effective methods of contraception including hormonal methods only after a pregnancy event, highlighting the need for earlier provision of youth-friendly SRH services.