Contraceptive use and unintended pregnancies among HIV-infected women in Mumbai

Joshi, Beena; Velhal, Gajanan; Chauhan, Sanjay; Kulkarni, Ragini; Begum, Shahina; Nandanwar, Y. S.; Fonseca, Michelle; Baweja, Sujata; Turbadkar, Dilip; Ramchandran, Anita; Dalal, Asha; Shastri, Jayanthi; Agrawal, Sachee; Panhale, Manisha; More,; Sanap, Pravin; R, Panchal; Kanougiya, Suman

doi:10.4103/0970-0218.158855

Cited by 15 publications

(17 citation statements)

References 11 publications

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“…Only 20 % of the participants desired children or more children and of that even lower percentage seek to become pregnant in coming 6 months. This finding was lower than the finding of such studies in other regions of the world especially Africa [ 23 , 31 – 33 ] but higher than in India [ 16 ]. Cultural factors are also important for fertility desire especially in sub-Saharan Africa and Asia [ 33 ].…”

Section: Discussioncontrasting

confidence: 79%

“…This could be true in our study as well, as all of the participants enrolled were aware of their HIV status. Similarly, the study from India has reported the number of children they already had as reasons for not wanting more children [ 16 ] which could also be true in our case. The total fertility rate (TFR) in Nepal is 2.17 and our study found that the mean number of children for the respondents as 1.96(±0.06) [ 22 ].…”

Section: Discussionsupporting

confidence: 74%

“…Although the Nepalese society also regards child bearing as an important life goals but HIV status seems to have negative impact on that. Even though we did not explore factors associated with fertility desire in our study, previous study has found that the knowledge of own HIV positive sero-status was significantly associated with limiting fertility desire and seek to prevent pregnancy using contraception [ 16 , 35 ]. This could be true in our study as well, as all of the participants enrolled were aware of their HIV status.…”

Section: Discussionmentioning

confidence: 99%

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Knowledge and utilization of family planning methods among people living with HIV in Kathmandu, Nepal

Pokharel

Bhattarai

Shrestha

et al. 2018

BMC Health Serv Res

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BackgroundAddressing 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.MethodsThis 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.ResultsThe 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.ConclusionThe 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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Section: Discussioncontrasting

confidence: 79%

Section: Discussionsupporting

confidence: 74%

Section: Discussionmentioning

confidence: 99%

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Knowledge and utilization of family planning methods among people living with HIV in Kathmandu, Nepal

Pokharel

Bhattarai

Shrestha

et al. 2018

BMC Health Serv Res

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“…This might be because more than half of the respondents were using hormonal contraceptives before their HIV diagnosis, making it easy to incorporate condom use in their sexual life. A study in India documented that nonuse of modern contraceptives with increased focus on condoms alone resulted in low uptake of dual method use [ 15 ]. Other similar studies show a higher hormonal contraceptive uptake among HIV-infected women on dual methods [ 42 , 43 ].…”

Section: Discussionmentioning

confidence: 99%

Factors associated with uptake of dual contraception among HIV-infected women in Bungoma County, Kenya: a cross-sectional study

Mulongo¹,

Lihana²,

Githuku³

et al. 2017

Pan Afr Med J

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Introductiondual 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.Methodsthis 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.Resultswe 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.Conclusiondual 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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“…This could be due to erroneous belief. Joshi et al [33] protected sex with HIV-negative/unknown status sex partners and those participants experienced higher rates of STI symptoms and diagnoses [30].…”

Section: Resultsmentioning

confidence: 99%

HIV Status Disclosure and Uptake of Female Condom among Women Accessing Antiretroviral Therapy Services at a Military Hospital in Lagos, Nigeria

Harrison¹,

Adegbite²,

Agbaim³

et al. 2019

WJA

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Background: Female condom (FC) has efficiently challenged the increased risk for sexually transmitted infections (STI)/HIV, unwanted pregnancy and promoted self-protection and autonomy among females. However, despite being provided free of charge, the researchers have not observed satisfactory level of demand for FC by the HIV-positive clients at our facility. This study sought to establish the determinants or deterrent factors to the uptake and the use of FC among HIV-infected female clients in an Army hospital, Lagos. Method: A cross-sectional descriptive design was used and 340 interviewees were selected for the survey. Analyses were completed using Epi Info TM version 7.2.1.0. Association between variables of interests was established using Chi-square. Result: Mean age of the participants was 37.91 ± 8.33 years while the median age was 37. Greater proportion was married (50.5%), business women (55.5%), had at least school certificate (90.1%), and had regular sexual partner (84.4%). Only 69.8% disclosed their status to their sexual partners, while 79.5% in turn were informed of their partners' HIV status. Being in marital union, younger age and being aware of partner's HIV status were significantly associated with HIV disclosure (p < 0.001). Contraceptive uptake was 59.8%, while FC use was 5.4%. Most reported limiting factors to FC utilization were non-availability (22.5%) and use of male condom by the partner (13.8%). Conclusion: Suboptimal HIV status disclosure, contraceptive use and very low FC uptake among participants need urgent attention to limit further spread of the virus, STI and prevent unwanted pregnancies.

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Contraceptive use and unintended pregnancies among HIV-infected women in Mumbai

Cited by 15 publications

References 11 publications

Knowledge and utilization of family planning methods among people living with HIV in Kathmandu, Nepal

Knowledge and utilization of family planning methods among people living with HIV in Kathmandu, Nepal

Factors associated with uptake of dual contraception among HIV-infected women in Bungoma County, Kenya: a cross-sectional study

HIV Status Disclosure and Uptake of Female Condom among Women Accessing Antiretroviral Therapy Services at a Military Hospital in Lagos, Nigeria

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