Pregnancy desire and dual method contraceptive use among people living with HIV attending clinical care in Kenya, Namibia and Tanzania

Details

• Alternative Title:
  J Fam Plann Reprod Health Care
• Personal Author:
  Antelman, Gretchen ; Medley, Amy ; Mbatia, Redempta ; Pals, Sherri ; Arthur, Gilly ; Haberlen, Sabina ; Ackers, Marta ; Elul, Batya ; Parent, Julie ; Rwebembera, Anath ; Wanjiku, Lucy ; Muraguri, Nicholas ; Gweshe, Justice ; Mudhune, Sandra ; Bachanas, Pamela
• Description:
  Aim
  
  To describe factors associated with pregnancy desire and dual method use among people living with HIV in clinical care in sub-Saharan Africa.
  
  Design
  
  Sexually active HIV-positive adults were enrolled in 18 HIV clinics in Kenya, Namibia and Tanzania. Demographic, clinical and reproductive health data were captured by interview and medical record abstraction. Correlates of desiring a pregnancy within the next 6 months, and dual method use [defined as consistent condom use together with a highly effective method of contraception (hormonal, intrauterine device (IUD), permanent)], among those not desiring pregnancy, were identified using logistic regression.
  
  Results
  
  Among 3375 participants (median age 37 years, 42% male, 64% on antiretroviral treatment), 565 (17%) desired a pregnancy within the next 6 months. Of those with no short-term fertility desire (n=2542), 686 (27%) reported dual method use, 250 (10%) highly effective contraceptive use only, 1332 (52%) condom use only, and 274 (11%) no protection. Respondents were more likely to desire a pregnancy if they were from Namibia and Tanzania, male, had a primary education, were married/cohabitating, and had fewer children. Factors associated with increased likelihood of dual method use included being female, being comfortable asking a partner to use a condom, and communication with a health care provider about family planning. Participants who perceived that their partner wanted a pregnancy were less likely to report dual method use.
  
  Conclusions
  
  There was low dual method use and low use of highly effective contraception. Contraceptive protection was predominantly through condom-only use. These findings demonstrate the importance of integrating reproductive health services into routine HIV care.
  
  
• Subjects:
  Adult Article Communication Condoms Contraception Contraception Behavior Female Fertility HIV Infections Humans Kenya Male Middle Aged Namibia Pregnancy Reproductive Health Services Tanzania

  More +
• Source:
  J Fam Plann Reprod Health Care. 41(1):e1
• Pubmed ID:
  25512359
• Pubmed Central ID:
  PMC4664147
• Document Type:
  Journal Article
• Funding:
  CC999999/Intramural CDC HHS/United States ; PEPFAR/United States
• Place as Subject:
  Kenya
• Volume:
  41
• Issue:
  1
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:42d11eb0aef6d386c1049244a55e8b2c428db5299b04e548b55b4132556d971b
• Download URL:
  https://stacks.cdc.gov/view/cdc/36242/cdc_36242_DS1.pdf
• File Type:
  [PDF - 552.16 KB ]