Contraceptive use among HIV-infected women and men receiving antiretroviral therapy in Lusaka, Zambia: a cross-sectional survey

L., Hancock, Nancy; Chibwesha, Carla J.; Bosomprah, Samuel; Newman, Jonathan; Mubiana‐Mbewe, Mwangelwa; Siyama, Sitali, Elizabeth; Bolton‐Moore, Carolyn; Mbwili-Muleya, Clara; Benjamin, H.

doi:10.1186/s12889-016-3070-5

Cited by 19 publications

(31 citation statements)

References 44 publications

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“…The finding was higher than the findings of Ghana (42.6%) [22], Tanzania (54%) [23], Malawi (51.2%) [24], and Horro Guduru Wollega zone, Ethiopia (46.6%) [25]. However, the current contraceptive use among respondents in this study is similar to studies among HIVpositive women in Cambodia (68.5%), Zambia (69%), Uganda (58%), and Dire Dawa, Ethiopia (69%) [26][27][28][29].…”

Section: Discussionsupporting

confidence: 70%

“…This will be a great concern for the risk of HIV transmission. This study reveals that a high proportion of women use implant among family planning users which is higher compared with the findings of other studies conducted in Ghana (7.1%), Tanzania (13.3%), and Zambia (8%) [22][23]28]. This may be explained by the availability of service at a lower health facility level (the service is provided by a health extension worker at a health post level in Ethiopia).…”

Section: Discussioncontrasting

confidence: 59%

“…A study conducted in Kenya showed that 73% of women and 71% of men thought that they or their partner would be more likely to use family planning if the services were offered at the HIV clinic [34]. Besides, a study in Zambia revealed that most respondents said they would access family planning services had it been available within the ART clinic [28].…”

Section: Discussionmentioning

confidence: 99%

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Status of family planning integration to HIV care in Amhara regional state, Ethiopia

Zewdie

Yitayal

Kebede

et al. 2020

BMC Pregnancy Childbirth

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Background: Preventing unintended pregnancies among HIV positive women is one component of HIV prevention strategies. However, programs to prevent mother-to-child transmission (PMTCT) of HIV started in antenatal care. The objective of this study was to examine the status of family planning integration to HIV care from client and facility perspectives and identify factors associated with current family planning use. Methods: A facility-based cross-sectional study was conducted from December 2017 to April 2018. Data were coded and double entered into EPI Info version 3.5.4 and exported to STATA version 14 for analysis. Bi-variable and multivariable logistic regression analyses were conducted to assess the association of variables with the current family planning use. Results: A total of 518 HIV-positive women were included in the study. Among HIV-positive women, 35.3% had an unmet need for family planning, and 21.4% responded that their pregnancies were unwanted. About two-thirds (68.1%) of women were using a modern family planning method at the time of the study. Among women who were currently using family planning, 88.8% got the service from a family planning clinic in the same facility, and only 1.1% got the service from the HIV care unit. Women who were not knowledgeable on PMTCT (AOR 0.47, 95% CI = 0.24-0.90), divorced or separated women (AOR 0.19, 95% CI = 0.10-0.37) and women in the age group of 25-34 years (AOR 0.42, 95% CI = 0.20-0.88) and 35-49 years (AOR 0.41, 95% CI = 0.17-0.99) were less likely to use modern family planning methods compared with those women who were knowledgeable, married and women in the age group of 15-24 years. Besides, women with higher income (AOR 2.12, 95% CI = 1.26-3.57) were more likely to use modern family planning methods compared with women with lower incomes. Conclusion: This study indicated that there is a high unmet need for family planning among HIV-positive women and low family planning services integration in the PMTCT/ART clinics. Efforts should be strengthened to tackle the factors which hinder the use of modern family planning and improve family planning service integration.

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Section: Discussionsupporting

confidence: 70%

Section: Discussioncontrasting

confidence: 59%

Section: Discussionmentioning

confidence: 99%

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Status of family planning integration to HIV care in Amhara regional state, Ethiopia

Zewdie

Yitayal

Kebede

et al. 2020

BMC Pregnancy Childbirth

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“…We found an overall contraceptive use of 62% in 2016. As compared to our result, some recent studies among women receiving ART in Ethiopia, Nigeria and Ghana reported a lower contraceptive rate, 44%, 36% and 43%, respectively [ 16 – 18 ], while a study in Zambia reported higher contraceptive use of 69% [ 19 ]. Unlike our study, however, family planning services were not fully integrated in HIV clinical care in these studies and most preferred methods were male condoms, except in Ethiopia.…”

Section: Discussioncontrasting

confidence: 63%

Contraceptive use and pregnancy rates among women receiving antiretroviral therapy in Malawi: a retrospective cohort study

et al. 2018

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BackgroundIn 2011, family planning (FP) services were integrated at Martin Preuss Centre (MPC), in urban Lilongwe, Malawi. To date, no previous study evaluated pregnancy rates among HIV-positive women after the integration of FP services into HIV care at the facility. In this study, we investigated whether integration of FP services into HIV clinical care led to increased use of contraceptives and decreased pregnancy rates.MethodsThis was a retrospective cohort analysis of HIV-positive women from 15 to 49 years of age who accessed antiretroviral therapy (ART) services at MPC. Ascertainment of FP needs, contraceptive methods and pregnancy status were done at ART initiation, and at each ART follow-up visit. Women were offered a wide range of contraceptive methods. Outcomes of interest were contraceptive use and rate of pregnancy. Incident pregnancy was ascertained through patient self-reports during clinic consultation. Trends of contraceptive use and pregnancy rates were analyzed using chi-square (χ2).ResultsA total of 10,472 women were included in the analysis and contributed 15,700 person-years of observation. Contraceptive use among all women receiving ART increased from 28% in 2012 to 62% in 2016 (p < 0.001). A total of 501 pregnancies occurred, including 13 multiple pregnancies, resulting in an overall pregnancy rates of 3.2 per 100 person-years. Rates of pregnancy decreased from 6.8 per 100 person-years in 2012 to 1.3 per 100 person-years in 2016 (p < 0.001).ConclusionIntegration of FP services into HIV care resulted in increased contraceptive use and, subsequently, decreased pregnancy rates in women receiving ART. HIV programs should consider offering FP services to women who are receiving ART.

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“…The prevalence of current modern contraceptive use among HIV-positive women in Kilimanjaro was higher than the national (32%) and the regional (47.8% - Kilimanjaro region) prevalence in the general population [ 14 ]. It is also higher than that observed among HIV-positive women in Ethiopia (46%) [ 24 ], Rwanda (43%) [ 25 ], Ghana (43%) [ 26 ], Lesotho (35%) [ 17 ] and Uganda (28%) [ 27 ] but lower than that in women on ART in Zambia (69%) [ 18 ] and among women attending CTC care in Dar es Salaam (68.5%) [ 28 ]. A higher contraceptive use among HIV-positive women than in the general population may be due to comprehensive counseling and guidance these women receive in various HIV interventions e.g.…”

Section: Discussionmentioning

confidence: 88%

Prevalence and factors influencing modern contraceptive use among HIV-positive women in Kilimanjaro region, northern Tanzania

Damian

George

Martin

et al. 2018

Contracept Reprod Med

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BackgroundMother-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.MethodsThis 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.ResultsIn 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.ConclusionsGiven 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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Contraceptive use among HIV-infected women and men receiving antiretroviral therapy in Lusaka, Zambia: a cross-sectional survey

Cited by 19 publications

References 44 publications

Status of family planning integration to HIV care in Amhara regional state, Ethiopia

Status of family planning integration to HIV care in Amhara regional state, Ethiopia

Contraceptive use and pregnancy rates among women receiving antiretroviral therapy in Malawi: a retrospective cohort study

Prevalence and factors influencing modern contraceptive use among HIV-positive women in Kilimanjaro region, northern Tanzania

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