BackgroundContext-specific factors influence adherence to antiretroviral therapy (ART) among pregnant women living with HIV. Gaps exist in the understanding of the reasons for the variable outcomes of the prevention of mother-to-child transmission (PMTCT) programme at the health facility level in South Africa. This study examined adherence levels and reasons for non-adherence during pregnancy in a cohort of parturient women enrolled in the PMTCT programme in the Eastern Cape, South Africa.MethodsThis was a mixed-methods study involving 1709 parturient women in the Eastern Cape, South Africa. We conducted a multi-centre retrospective analysis of the mother-infant pair in the PMTCT electronic database in 2016. Semi-structured interviews of purposively selected parturient women with self-reported poor adherence (n = 177) were conducted to gain understanding of the main barriers to adherence. Binary logistic regression was used to determine the independent predictors of ART non-adherence.ResultsA high proportion (69.0%) of women reported perfect adherence. In the logistic regression analysis, after adjusting for confounding factors, marital status, cigarette smoking, alcohol use and non-disclosure to a family member were the independent predictors of non-adherence. Analysis of the qualitative data revealed that drug-related side-effects, being away from home, forgetfulness, non-disclosure, stigma and work-related demand were among the main reasons for non-adherence to ART.ConclusionsNon-adherence to the antiretroviral therapy among pregnant women in this setting is associated with lifestyle behaviours, HIV-related stigma and ART side-effects. In order to eliminate mother-to-child transmission of HIV, clinicians need to screen for these factors at every antenatal clinic visit.

Background Most studies on HIV testing among young people in Nigeria are not nationally representative. As such, recent nationally representative data, such as the Multiple Indicator Cluster Survey (MICS), could help assess the current level of HIV testing among young people, a key target population for HIV prevention in the country. In this study, we examined the coverage and factors associated with HIV testing among adolescents and young adults (AYA).

BackgroundContraceptive use has numerous health benefits such as preventing unplanned pregnancies, ensuring optimum spacing between births, reducing maternal and child mortality, and improving the lives of women and children in general. This study examines the level of contraceptive use, its determinants, reasons for non-use of contraception among women in the reproductive age group (18–49 years) in two southwestern Nigerian states.MethodsThe study adopted an interviewer-administered questionnaire to collect data from 809 participants selected using a 3-stage cluster random sampling technique. We also conducted 46 in-depth interviews. In order to investigate the association between the socio-demographic variables and use of contraceptive methods, we estimated the binary logistic regression models.ResultsThe findings indicated that knowledge of any methods of contraception was almost universal among the participants. The rates of ever use and current use of contraception was 80 and 66.6%, respectively. However, only 43.9% of the participants had ever used any modern contraceptive methods, considered to be more reliable. The fear of side effects of modern contraceptive methods drove women to rely on less effective traditional methods (withdrawal and rhythm methods). Some women employed crude and unproven contraceptive methods to prevent pregnancies.ConclusionOur findings show that the rate of contraceptive use was high in the study setting. However, many women chose less effective traditional contraceptive methods over more effective modern contraceptive methods due to fear of side effects of the latter. Patient education on the various options of modern contraceptives, their side effects and management would be crucial towards expanding the family planning services in the study setting.

BackgroundIntegration of family planning services into HIV care was implemented in South Africa as a core strategy aimed at reducing unintended pregnancies among childbearing women living with HIV. However, it is unclear whether this strategy has made any significant impact at the population level. This paper describes the prevalence and correlates of self-reported unplanned pregnancy among HIV-infected parturient women attending three large maternity centres in the Eastern Cape, South Africa. We also compare unplanned pregnancy rates between HIV-infected parturient women already in care (who have benefitted from services’ integration) and newly diagnosed parturient women (who have not benefitted from services’ integration).MethodsDrawing from the baseline data of the East London Prospective Cohort Study (ELPCS), data of 594 parturient women living with HIV in the Eastern Cape were included. Chi-square statistics and binary logistics regression were employed to determine the correlates of unplanned pregnancy among the cohort.ResultsThe prevalence of unplanned pregnancy was 71% (n = 422) with a higher rate among parturient women newly diagnosed during the index pregnancy (87%). Unplanned pregnancy was significantly associated with younger age, single status, HIV diagnosis at booking, high parity and previous abortion. Women who reported unplanned pregnancy were more likely to book late and have lower CD4 counts. After adjusting for confounding variables, having one child and five to seven children (AOR = 2.2; CI = 1.3–3.1), age less than 21 years (AOR = 3.3; CI = 1.1–9.8), late booking after 27 weeks (AOR = 2.7; CI = 1.5–5.0), not married (AOR = 4.3; CI = 2.7–6.8) and HIV diagnosis at booking (AOR = 3.0; CI = 1.6–5.8) were the significant correlates of unplanned pregnancy in the cohort.ConclusionUnplanned pregnancy remains high overall among parturient women living with HIV in the region, however, with significant reduction among those who were exposed to integrated services. The study confirms that integration of HIV care and family planning services is an important strategy to reduce unplanned pregnancy among women living with HIV. The study’s findings have significant implications for the elimination of mother-to-child transmission of HIV in South Africa. Innovative interventions are needed to further consolidate and maximise the benefit of the integration of family planning services with HIV care.

Background Consistent condom use is central to the prevention of transmission of human immunodeficiency virus (HIV) and other sexually transmitted diseases (STDs), especially among young adults. This study drew from a cross-sectional survey of two Nigerian universities to determine the level of consistent condom use, explored the determinants of condom use consistency and reasons for inconsistent condom use. Methods We adopted a descriptive cross-sectional design, which involves the recruitment of 800 male and female students using stratified random sampling. Adjusted and unadjusted logistic regression models were used to examine the factors associated with consistent condom use among a final sample of 498 students who engaged in sex in the last year preceding the study. Results Only 38.6% of sexually active participants ( n = 498) used condoms consistently in the previous year. High condom self-efficacy score (AOR: 2.40; 95% CI: 1.58–3.64), discussion of HIV/STIs with sexual partner (AOR: 1.91; 95%CI: 1.29–2.83), knowing partner’s HIV status (AOR: 1.48; 95% CI: 1.02–2.16), being students of university located in a high HIV prevalence area (AOR: 2.86; 95% CI: 1.92–4.28) and engaging in sex with only steady partner (AOR: 1.74; 95% CI: 1.17–2.60) were associated with a higher odds of consistent condom use. Trust, unavailability of condoms, dislike of condoms and a perception that condoms reduced sexual pleasure were the main reasons for inconsistent use of condoms. Conclusion The study found a low level of consistent condom use among study participants. Counselling young adults in Nigeria on condom self-efficacy, providing condoms on campuses and encouraging the discussion of sexually transmitted infections with sexual partners are central to improving the level of consistent condom use among Nigerian university students. Electronic supplementary material The online version of this article (10.1186/s12889-019-7543-1) contains supplementary material, which is available to authorized users.