Safer conception for female sex workers living with HIV in Dar es Salaam, Tanzania: Cross-sectional analysis of needs and opportunities in integrated family planning/HIV services

Abstract

Background With the advent of effective treatment, women living with HIV can plan for pregnancy while minimizing risk of transmission to infants and seronegative partners. Family planning (FP) services tend to focus solely on addressing contraceptive need, but HIV-positive womenincluding female sex workers-often plan to have children someday. Various "safer conception" strategies are now available to support women living with HIV achieve fertility intentions, and integrated HIV/FP services may be a promising platform to offer these services. Methods At integrated community-based HIV/FP service delivery sites operated by Jhpiego's Sauti project in Dar es Salaam, we conducted exit interviews with 300 HIV-positive female sex workers. Descriptive analyses were conducted to describe their desire for children, use of condoms and other modern contraceptive methods, self-reported viral suppression, and knowledge of and interest in safer conception strategies. We conducted bivariate and multivariate logistic regression analysis to examine correlates of fertility desire among respondents. Results Median age of participants was 32. Nearly one-third wished to have a child within two years. Seventy-two percent had heard of having the HIV-positive partner taking ART to reduce sexual transmission during pregnancy attempts. Thirty-one percent felt the amount of FP content covered in the consultation was "too little." Factors significantly associated with desire for children were having a nonpaying partner (adjusted odds ratio [AOR] 2.18, 95% confidence interval [CI]1.13-4.20) and having fewer children (AOR 0.65, 95% CI 0.48-0.87). Viral suppression was not associated with fertility desire.

Family Planning Experiences and Needs of Young Women Living With and Without HIV Accessing an Integrated HIV and SRH Intervention in Zimbabwe-An Exploratory Qualitative Study

“…Our findings support those from other studies that have shown that supportive provider-client relationships are crucial for helping young people seek and adhere to ART and prevent unintended pregnancies through family planning care ( 47 , 48 ). Therefore, in the context of HIV care, where individuals are seen repeatedly, there is an opportunity to develop such relationships.…”

Women Who Sell Sex in Eastern and Southern Africa: A Scoping Review of Non-Barrier Contraception, Pregnancy and Abortion

“…Non- paying partner request and being born in a rural area contributed to pregnancy desire for their Malawian participants. This is confirmed in a Tanzanian study [ 43 ]. in which just under one-third of participants desired having a child in the next 2 years.…”

“…In a South African study [ 25 ], 59.3% of women knew of ARV-based methods for safer conception, and 14.3% of non-ARV methods. In Tanzania [ 43 ], 90% of participants knew of one safer conception method, with 72% having heard of having the seropositive partner taking ART.…”

Saúde sexual e reprodutiva de mulheres com HIV/aids: revisão integrativa

“…Ao analisar os objetivos, os estudos puderam ser reunidos em três grupos por semelhanças. O primeiro grupo buscou explorar as experiências de mulheres com HIV nos serviços de saúde, no que tange às barreiras e aos desafios encontrados (12,16,22,24,(26)(27)34) , às trajetórias reprodutivas percorridas (19,33,(35)(36) , ao HIV como o influenciador da assistência recebida (23,32) e ao aprimoramento da assistência ofertada (25,30) .…”

“…Yam et al, 2020 (33) A maioria das participantes relataram que a quantidade de conteúdo de planejamento familiar abordado nas consultas era "muito pouco".…”