Oral and injectable contraceptive use and HIV acquisition risk among women in four African countries: a secondary analysis of data from a microbicide trial

RésuméCet article examine le recours à la contraception dans les capitales de quatre pays africains, le Burkina Faso, le Ghana, le Maroc et le Sénégal. L’article cherche à répondre à deux questions : (i) quel est l’ordre hiérarchique des relations causales entre les caractéristiques individuelles associées au recours à la contraception dans les quatre populations urbaines considérées ? Plus particulièrement, (ii) comme l’instruction est un facteur majeur de la transition démographique, les données confirment-elles les deux chemins indirects allant de l’instruction au recours à la contraception qui ont été proposés dans la littérature, à savoir un chemin union-reproduction et un chemin socio-culturel ? À partir d’une analyse secondaire des Enquêtes Démographie et Santé (EDS), la méthodologie se base sur des modèles structurels récursifs représentés par des graphes acycliques orientés. L’analyse empirique confirme l’importance de variables telles que le désir d’enfants et l’accord parental en matière de planification familiale pour expliquer le recours à la contraception. L’analyse met aussi en relief un chemin structurel union-reproduction associant instruction féminine et recours à la contraception. En revanche, l’analyse aboutit à rejeter l’existence d’un chemin socioculturel, celui-ci étant infirmé par les données disponibles. La validité de ces résultats est discutée.AbstractThis study examined contraceptive use in the capital cities of four African countries, Burkina Faso, Ghana, Morocco and Senegal. The article sought to answer two questions: (i) what is the hierarchical ordering of causal relationships among the individual factors involved in the use of contraception in the four urban populations considered? More particularly, (ii) as education is a major factor of fertility transition, are two main indirect pathways that have been proposed in the literature (a union-reproductive path and a socio-cultural one), leading from women’s education to contraceptive use, confirmed by the data? Having recourse to a secondary analysis of Demographic and Health Survey (DHS) data, the methodology is based on recursive structural models represented by directed acyclic graphs. The empirical analysis confirms the importance of variables such as the desire for children and partner agreement on family planning in explaining contraceptive use. It also highlights a structural union-reproductive path linking female education and contraceptive use. On the contrary, the analysis leads to a tentative rejection of the socio-cultural path, as it is falsified by the data available. The validity of these results is discussed.

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High prevalence of non-dipping patterns among Black Africans with uncontrolled hypertension: a secondary analysis of the CREOLE trial

BMC Cardiovascular Disorders ◽

10.1186/s12872-021-02074-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Prossie Merab Ingabire ◽

◽

Dike B. Ojji ◽

Brian Rayner ◽

Elijah Ogola ◽

...

Keyword(s):

Blood Pressure ◽

Blood Pressure Monitoring ◽

Secondary Analysis ◽

Uncontrolled Hypertension ◽

African Countries ◽

Night Time ◽

Black Africans ◽

Long Term Outcome ◽

Black African ◽

High Prevalence

Abstract Background Dipping of blood pressure (BP) at night is a normal physiological phenomenon. However, a non-dipping pattern is associated with hypertension mediated organ damage, secondary forms of hypertension and poorer long-term outcome. Identifying a non-dipping pattern may be useful in assessing risk, aiding the decision to investigate for secondary causes, initiating treatment, assisting decisions on choice and timing of antihypertensive therapy, and intensifying salt restriction. Objectives To estimate the prevalence and factors associated with non-dipping pattern and determine the effect of 6 months of three antihypertensive regimens on the dipping pattern among Black African hypertensive patients. Methods This was a secondary analysis of the CREOLE Study which was a randomized, single blind, three-group trial conducted in 10 sites in 6 Sub-Saharan African countries. The participants were 721 Black African patients, aged between 30 and 79 years, with uncontrolled hypertension and a baseline 24-h ambulatory blood pressure monitoring (ABPM). Dipping was calculated from the average day and average night systolic blood pressure measures. Results The prevalence of non-dipping pattern was 78% (564 of 721). Factors that were independently associated with non-dipping were: serum sodium > 140 mmol/l (OR = 1.72, 95% CI 1.17–2.51, p-value 0.005), a higher office systolic BP (OR = 1.03, 95% CI 1.01–1.05, p-value 0.003) and a lower office diastolic BP (OR = 0.97, 95% CI 0.95–0.99, p-value 0.03). Treatment allocation did not change dipping status at 6 months (McNemar’s Chi2 0.71, p-value 0.40). Conclusion There was a high prevalence of non-dipping among Black Africans with uncontrolled hypertension. ABPM should be considered more routinely in Black Africans with uncontrolled hypertension, if resources permit, to help personalise therapy. Further research is needed to understand the mechanisms and causes of non-dipping pattern and if targeting night-time BP improves clinical outcomes. Trial registration ClinicalTrials.gov (NCT02742467).

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Factors Influencing Contraceptive Use in Sub-Saharan Africa: A Systematic Review

International Quarterly of Community Health Education ◽

10.1177/0272684x16685254 ◽

2017 ◽

Vol 37 (2) ◽

pp. 79-91 ◽

Cited By ~ 46

Author(s):

Sarah R. Blackstone ◽

Ucheoma Nwaozuru ◽

Juliet Iwelunmor

Keyword(s):

Contraceptive Use ◽

Male Partner ◽

Sub Saharan Africa ◽

Modern Contraceptive ◽

African Countries ◽

Factors Influencing ◽

Contraceptive Side Effects ◽

Modern Contraceptive Use ◽

Negative Perceptions ◽

Sub Saharan

The purpose of this study was to systematically review the literature regarding factors influencing contraceptive use in sub-Saharan Africa between 2005 and 2015. A total of 58 studies from twelve Sub-Saharan African countries were reviewed. Keywords were grouped using the PEN-3 cultural model. Negative factors prohibiting or reducing contraceptive use were women’s misconceptions of contraceptive side–effects, male partner disapproval, and social/cultural norms surrounding fertility. Positive factors included education, employment, and communication with male partner. Increasing modern contraceptive use in Sub-Saharan Africa is a multi-faceted problem that will require community and systems wide interventions that aim to counteract negative perceptions and misinformation.

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Dual Method Use among Postpartum HIV-Infected and HIV-Uninfected Malawian Women: A Prospective Cohort Study

Infectious Diseases in Obstetrics and Gynecology ◽

10.1155/2017/1475813 ◽

2017 ◽

Vol 2017 ◽

pp. 1-9 ◽

Cited By ~ 2

Author(s):

Dawn M. Kopp ◽

Jennifer H. Tang ◽

Gretchen S. Stuart ◽

William C. Miller ◽

Michele S. O’Shea ◽

...

Keyword(s):

Condom Use ◽

Contraceptive Use ◽

Secondary Analysis ◽

Dual Method ◽

Hiv Status ◽

Telephone Surveys ◽

Prevalence Ratios ◽

Effective Contraceptive Method ◽

Effective Contraceptive

Dual method use, use of condoms plus another effective contraceptive method, is important in settings with high rates of unintended pregnancy and HIV infection. We evaluated the association of HIV status with dual method use in a cohort of postpartum women. Women completed baseline surveys in the postpartum ward and telephone surveys about contraceptive use 3, 6, and 12 months later. Nonpregnant women who completed at least one follow-up survey were eligible for this secondary analysis. Prevalence ratios were calculated using generalized estimating equations. Of the 511 sexually active women who completed a follow-up survey, condom use increased from 17.6% to 27.7% and nonbarrier contraceptive use increased from 73.8% to 87.6% from 3 to 12 months after delivery. Dual method use increased from 1.0% to 18.9% at 3 to 12 months after delivery. Dual method use was negligible and comparable between HIV-infected and HIV-uninfected women at 3 months but significantly higher among HIV-infected women at 6 months (APR = 3.9, 95% CI 2.2, 7.1) and 12 months (APR = 2.7, 95% CI 1.7, 4.3). Dual method use was low but largely driven by condom use among HIV-infected women at 6 and 12 months after delivery.

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International Migration and Modern Contraceptive Use: A Research Note on African Migrants to France

Demography ◽

10.1215/00703370-9611478 ◽

2021 ◽

Author(s):

Julia A. Behrman ◽

Michelle A. Eilers ◽

Isabel H. McLoughlin Brooks ◽

Abigail Weitzman

Keyword(s):

Contraceptive Use ◽

Family Background ◽

Research Note ◽

Demographic And Health Surveys ◽

Modern Contraceptive ◽

African Countries ◽

Proximate Determinant ◽

African Migrants ◽

Modern Contraceptive Use ◽

Long Acting

Abstract This research note presents a multisited analysis of migration and contraceptive use by standardizing and integrating a sample of African migrants in France from six West and Central African countries in the Trajectoires et Origines survey with a sample of women living in the same six African countries in the Demographic and Health Surveys. Descriptive analyses indicate that the contraceptive use of migrants more closely aligns with that of native French women than with that of women from origin countries. In particular, migrants report dramatically higher use of long-acting reversible contraceptives and short-acting hormonal methods and lower use of traditional methods than do women in the countries of origin. Although migrants differ from women in the countries of origin on observed characteristics, including education and family background, reweighting women in the origin countries to resemble migrants on these characteristics does little to explain differences in contraceptive use between the groups. Given that contraceptive use is an important proximate determinant of fertility, our results suggest that contraceptive use should feature more prominently in the dominant demographic paradigms of migrant fertility.

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Predictors of Modern Contraceptive Use Among Married Women in Angola: A Population Based Study

10.21203/rs.3.rs-53360/v1 ◽

2020 ◽

Author(s):

Betregiorgis Hailu Zegeye ◽

Gashaw Woldeamanuel Garedew ◽

Wassie Negash ◽

Balkew Tegegn Asegidew

Keyword(s):

Contraceptive Use ◽

Population Based ◽

Married Women ◽

P Value ◽

Modern Contraceptive ◽

African Countries ◽

Modern Contraceptive Use ◽

Nationally Representative ◽

The Government ◽

Living Children

Abstract Background: Maternal mortality is unacceptability high in Sub-Saharan-African countries including Angola. Despite family planning is one of the vital intervention to reduce maternal death, the coverage of modern contraceptive use in Angola is extremely low and there is a paucity of evidence regarding current factors associated with contraceptive use in Angola. Therefore, this study aimed at investigating predictors of contraceptive use among married women in Angola using nationally representative data.Methods: The data were extracted from 2015/16 Angola Multiple Indicator and Health Survey for this study and approximately 8,033 married women aged 15 - 49 years were participated. Bivariate and multivariate logistic regression were performed using STATA version 14 software to identify the predictors, and p-value less than 0.05 was considered as statistically significant.Results: The coverage of modern contraceptive use among married women was 8.9%. Maternal age, women’s educational level, maternal occupation, place of residence, media exposure, number of living children, desire for more children and subnational region were main predictors for modern contraceptive use.Conclusion: Modern contraceptive use among married women in Angola was very low. Married women who were educated, wealthiest, exposed for media, who had living children, interested to have child after 2 years and those who were not interested to have at all were more likely to use contraceptive. Therefore, the government of Angola and other concerned bodies need to emphasize in empowering women through education and economy as well as dissemination of contraceptive related information through media especially for women’s living in rural settings.

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