scholarly journals The prevalence of unintended pregnancy and its association with HIV status among pregnant women in South Africa, a national antenatal survey, 2019

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Selamawit Woldesenbet ◽  
Tendesayi Kufa ◽  
Carl Lombard ◽  
Samuel Manda ◽  
Diane Morof ◽  
...  
Keyword(s):  
South Africa ◽  
Pregnant Women ◽  
Unintended Pregnancy ◽  
Unplanned Pregnancy ◽  
Multivariable Analysis ◽  
Pregnancy Intention ◽  
Antenatal Visit ◽  
Hiv Status ◽  
Reproductive Health Services ◽  
Cross Sectional Survey

AbstractTo describe the prevalence of unintended pregnancy and its association with HIV status among pregnant women in South Africa. A cross-sectional survey was conducted between October and mid-November 2019 among pregnant women aged 15–49 years in 1589 selected public antenatal care facilities. Pregnancy intention was assessed using two questions from the London Measure of Unplanned Pregnancy. Survey logistic regression examined factors associated with unintended pregnancy. Among 34,946 participants, 51.6% had an unintended pregnancy. On multivariable analysis, the odds of unintended pregnancy was higher among women who knew their HIV-positive status before pregnancy but initiated treatment after the first antenatal visit (adjusted odds ratio [aOR], 1.5 [95% confidence interval (CI):1.2–1.8]), women who initiated treatment before pregnancy (aOR, 1.3 [95% CI:1.2–1.3]), and women with a new HIV diagnosis during pregnancy (aOR, 1.2 [95% CI:1.1–1.3]) compared to HIV-negative women. Women who were single, in a non-cohabiting or a cohabiting relationship, and young women (15–24 years) had significantly higher risk of unintended pregnancy compared to married women and women aged 30–49 years, respectively. A comprehensive approach, including regular assessment of HIV clients’ pregnancy intention, and adolescent and youth-friendly reproductive health services could help prevent unintended pregnancy.

scholarly journals Reliability and validity of an individually focused food insecurity access scale for assessing inadequate access to food among pregnant Ugandan women of mixed HIV status

2014 ◽  
Vol 18 (16) ◽  
pp. 2895-2905 ◽  
Author(s):  
Barnabas K Natamba ◽  
Hillary Kilama ◽  
Angela Arbach ◽  
Jane Achan ◽  
Jeffrey K Griffiths ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Food Insecurity ◽  
Pregnant Women ◽  
Internal Displacement ◽  
Northern Uganda ◽  
Cognitive Interviews ◽  
Hiv Status ◽  
Cross Sectional Survey ◽  
Care Clinic ◽  
Food Insecurity Access

AbstractObjectiveTo determine the reliability, validity and correlates of measures of food insecurity (FI) obtained using an individually focused food insecurity access scale (IFIAS) among pregnant women of mixed HIV status in northern Uganda.DesignA mixed-methods study involving cognitive interviews nested within a cross-sectional survey.SettingThe antenatal care clinic of Gulu Regional Referral Hospital.SubjectsSurvey respondents included 403 pregnant women, recruited in a ratio of one HIV-infected to two HIV-uninfected respondents, twenty-six (nine of them HIV-infected) of whom were asked to participate in the cognitive interviews.ResultsOver 80 % of cognitive interview participants reported understanding the respective meanings of six of the nine items (i.e. items 4 to 9) on the IFIAS. Two main factors emerged from rotated exploratory factor analysis of the IFIAS: mild to moderate FI (IFIAS items 1–6) and severe FI (items 7–9). Together, they explained 90·4 % of the FI measure’s variance. The full IFIAS and the two subscales had moderate to high internal consistency (Cronbach’s α ranged from 0.75 to 0.87). Dose–response associations between IFIAS scores, and measures of socio-economic status and women’s diet quality, were observed. Multivariate linear regression revealed significant positive associations between IFIAS scores and HIV infection, maternal age, number of children and a history of internal displacement. IFIAS scores were negatively associated with women’s diet diversity score, asset index and being employed.ConclusionsThe IFIAS showed strong reliability, validity and contextual relevance among women attending antenatal care in northern Uganda.

scholarly journals Patterns and Predictors of HIV-Status Disclosure Among Pregnant Women in South Africa: Dimensions of Disclosure and Influence of Social and Economic Circumstances

2018 ◽  
Vol 22 (12) ◽  
pp. 3933-3944 ◽  
Author(s):  
Kirsty Brittain ◽  
Claude A. Mellins ◽  
Robert H. Remien ◽  
Tamsin Phillips ◽  
Allison Zerbe ◽  
...  
Keyword(s):  
South Africa ◽  
Pregnant Women ◽  
Hiv Status ◽  
Hiv Status Disclosure ◽  
Status Disclosure

scholarly journals Sexual Activity, Knowledge of Contraceptives Use among Females Choosing Termination of Pregnancy at a Provincial Clinic in South Africa

2019 ◽  
Vol 12 (1) ◽  
pp. 60
Author(s):  
Charity C Mazuba ◽  
Kefiloe A Maboe ◽  
Annalie D H Botha
Keyword(s):  
South Africa ◽  
High School ◽  
Reproductive Health ◽  
Sexual Activity ◽  
Tertiary Education ◽  
Termination Of Pregnancy ◽  
Health Clinic ◽  
Reproductive Health Services ◽  
Cross Sectional Survey ◽  
Emergency Contraceptives

This study investigated sexual activity, knowledge of contraceptives use among females choosing termination of pregnancy (TOP) at a provincial clinic in South Africa. This was a quantitative and observational study in the form of a cross-sectional survey. A pre-tested self-administered questionnaire was used to collect data from 61 respondents who had terminated their pregnancies. Almost ninety-two (91.8%) percent of the respondents were single women between 18 and 27 years of age. Their level of education showed that 32% had completed high school, 28% were high school learners, 21.1% were tertiary education level learners and 1.8% had tertiary education. The frequency of sexual activity was mostly once a month (40%), followed by once a week (36.5%). Unemployment was high (36%), making the respondents dependent on government grants. Most of the women were aware of contraceptives methods (88.5%). The majority of the respondents (75.4%) have heard about emergency contraceptives (EC), while only 11.5% had never heard of contraceptives in general. The condom was the most popular method (54.1%), followed by the injection (45.9%). However, although 88.5% and 75.4% have heard of emergency contraceptives, their knowledge of contraceptives in general was very low. Contraceptives were used by 78.6% before termination of their pregnancy (TOP) and the most frequently used method was the injection at 36.6%. The respondents were the initiators of TOP. The researchers recommended that awareness of contraceptives should be promoted, and programmes aimed at changing the behaviour of sexually active females should be designed in order for them to make use of reproductive health services and family planning. Continuous education on sexual activities and contraceptives needs to be given to women visiting a reproductive health clinic. Policymakers should facilitate access to modern contraceptives and promote their effectiveness in all disadvantaged communities, thus addressing the root cause of the termination of unplanned pregnancies.

scholarly journals Maternal pregnancy intention and its association with low birthweight and pregnancy complications in Bangladesh: findings from a hospital-based study

2019 ◽  
Vol 11 (6) ◽  
pp. 447-454
Author(s):  
Mosfequr Rahman ◽  
Sarkar Obaida Nasrin ◽  
Mosiur Rahman ◽  
Aminur Rahman ◽  
Golam Mostofa ◽  
...  
Keyword(s):  
Unintended Pregnancy ◽  
Pregnancy Complications ◽  
Low Birthweight ◽  
Pregnancy Intention ◽  
Cross Sectional Survey ◽  
College Hospital ◽  
Cross Sectional ◽  
Unintended Pregnancies ◽  
Effective Interventions ◽  
Increased Risk

ABSTRACT Background The investigation of the potential impact of unintended pregnancy on maternal and child health is important to design effective interventions. This study explored the associations between unintended pregnancy and low birthweight (LBW) and pregnancy complications. Methods A cross-sectional survey was conducted among 400 randomly selected women in the postnatal wards of Rajshahi Medical College Hospital, Bangladesh. Multivariate logistic regression analyses were used to identify associations. Results Results of this study indicate that 30.5% of all pregnancies were unintended and 29.3% of babies were born with LBW. Additionally, 79.3% of women experienced any pregnancy complication (AC), 69.5% experienced medical complications and 44.3% experienced obstetric complications (OCs) during their last pregnancy. Unintended pregnancy was significantly associated with LBW (adjusted odds ratio [AOR]: 3.18, 95% CI: 1.79 to 5.54), maternal experience of OCs (AOR: 1.83, 95% CI: 1.03 to 3.28) and AC (AOR: 2.93, 95%: 1.14 to 7.58). Women with unintended pregnancies were at higher risk of developing high blood pressure and anemia during pregnancy. Conclusions Women with unintended pregnancies are at increased risk of producing LBW babies and experiencing complications during pregnancy. Therefore, maternal pregnancy intention should be addressed in interventions aimed to reduce maternal and child morbidity and mortality.

Determinants of Gender Disparities in Scaling Up the First 90 Towards the UNAIDS 90-90-90 Targets in South Africa: Findings From the 2017 Household-based National Cross-sectional Survey

2020 ◽  
Author(s):  
Sean Jooste ◽  
Musawenkosi Mabaso ◽  
Myra Taylor ◽  
Alicia North ◽  
Yolande Shean ◽  
...  
Keyword(s):  
South Africa ◽  
Tertiary Education ◽  
Hiv Treatment ◽  
Hiv Positive ◽  
People Living With Hiv ◽  
Hiv Status ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Primary Level ◽  
Treatment Cascade

Abstract Background: The first 90 of UNAIDS 90–90–90 targets to have 90% of the people living with HIV know their status is an important entry point to the HIV treatment cascade and care continuum, but evidence shows that there is a large gap between males and females in this regard. It is therefore important to understand barriers and facilitators of achieving the first 90 target. This study examined determinants of the first 90 target among females and males in order to inform strategies aimed at improving the HIV cascade in South Africa.Methods: The data used in the analysis were obtained from a 2017 household-based cross-sectional nationally representative survey conducted using a multi-stage stratified cluster random sampling design. A series of hierarchical multiple logistic regression models were fitted to identify the determinants of the first 90 target by gender.Results: Overall, 84.8% of HIV-positive individuals aged 15 years and older were aware of their HIV status. Females were significantly more aware of their HIV status compared to males (88.7% vs 78.2%, p<0.001). Both females aged 25 to 49 years [aOR=3.20 (95% CI: 1.35–7.57), p=0.008], and 50 years and older [aOR=3.19 (95% CI: 1.04–9.76), p=0.042] and males aged 25 to 49 years [aOR=3.00 (95% CI: 1.13–7.97), p=0.028], and 50 years and older [aOR=7.25 (95% CI: 2.07–25.36), p=0.002] were significantly more likely to know their HIV status compared to those aged 15 to 19 years. Males with tertiary education level were significantly more likely to be aware of their HIV positive status [aOR=75.24 (95% CI: 9.07–624.26), p<0.001] compared to those with no education or with primary level education. Females with secondary [aOR=3.28 (95% CI: 1.20–8.99), p=0.021] and matric [aOR=4.35 (95% CI: 1.54–12.37), p=0.006] educational levels were significantly more likely to be aware of their HIV positive status, compared to those with no education or with primary level education.Conclusion: Significant progress has been made with regards to reaching the UNAIDS first 90 target. In this context achieving the first 90 target is feasible but there is a need for additional interventions to reach the males especially youth including those with no education or low levels of education.

scholarly journals Association between sexual violence and unintended pregnancy among adolescent girls and young women in South Africa

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Anthony Idowu Ajayi ◽  
Henrietta Chinelo Ezegbe
Keyword(s):  
South Africa ◽  
Sexual Violence ◽  
Unintended Pregnancy ◽  
Adolescent Girls ◽  
Young Women ◽  
Teenage Pregnancy ◽  
Multivariable Analysis ◽  
Limited Attention ◽  
Cross Sectional ◽  
Unintended Pregnancies

Abstract Background Unintended pregnancy has dire consequences on the health and socioeconomic wellbeing of adolescent girls and young women (AGYW) (aged 15–24 years). While most studies tend to focus on lack of access to contraceptive information and services, and poverty as the main contributing factor to early-unintended pregnancies, the influence of sexual violence has received limited attention. Understanding the link between sexual violence and unintended pregnancy is critical towards developing a multifaceted intervention to reduce unintended pregnancies among AGYW in South Africa, a country with high teenage pregnancy rate. Thus, we estimated the magnitude of unintended pregnancy among AGYW and also examined the effect of sexual violence on unintended pregnancy. Methods Our study adopted a cross-sectional design, and data were obtained from AGYW in a South African university between June and November 2018. A final sample of 451 girls aged 17–24 years, selected using stratified sampling, were included in the analysis. We used adjusted and unadjusted logistic regression analysis to examine the effect of sexual violence on unintended pregnancy. Results The analysis shows that 41.9% of all respondents had experienced an unintended pregnancy, and 26.3% of those unintended pregnancies ended in abortions. Unintended pregnancy was higher among survivors of sexual violence (54.4%) compared to those who never experienced sexual abuse (34.3%). In the multivariable analysis, sexual violence was consistently and robustly associated with increased odds of having an unintended pregnancy (AOR:1.70; 95% CI: 1.08–2.68). Conclusion Our study found a huge magnitude of unintended pregnancy among AGYW. Sexual violence is an important predictor of unintended pregnancy in this age cohort. Thus, addressing unintended pregnancies among AGYW in South Africa requires interventions that not only increase access to contraceptive information and services but also reduce sexual violence and cater for survivors.

scholarly journals Utilization of delivery services in the context of Prevention of HIV from Mother- To-Child (PMTCT) in a rural community, South Africa

Curationis ◽  
2006 ◽  
Vol 29 (1) ◽  
Author(s):  
K Peltzer ◽  
T Mosala ◽  
O Shisana ◽  
A Nqeteko
Keyword(s):  
South Africa ◽  
Pregnant Women ◽  
Rural Community ◽  
Traditional Birth Attendant ◽  
Care Facility ◽  
Hiv Knowledge ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Delivery Services ◽  
Mother To Child

The aim of this study was to investigate the utilization of delivery services in the context of PMTCT in a rural community in South Africa. Based on a cross-sectional survey, the sample included 870 pregnant women who had delivered before recruited from five PMTCT clinics and surrounding communities. Results indicated that 55.9% had delivered their last child in a health care facility and 44.1% at home (mostly without assistance from a traditional birth attendant). The odds of access to the health facility were (1) women who stayed close to the hospital (OR=2.87), (2) those who had higher formal education (OR=l .55), (3) higher traveling costs (affordability) to get to nearest clinic (OR=1.77), and (4) those who were single (OR=1.58). Childbirth experiences of the mother or mother-in-law greatly influenced the delivery choices in terms of home delivery. The majority of the pregnant women were aware of mother-to-child HIV transmission but only 9% of the pregnant women had ever been tested for HIV. HIV knowledge, HIV testing behaviour and attitudes were found to be not associated with the delivery option.

scholarly journals Health Education Needs of First Visit Pregnant Women in Antenatal Clinics in Khayelitsha, South Africa

2020 ◽  
Vol 22 (1) ◽  
Author(s):  
Thabani Noncungu ◽  
Jennifer Chipps
Keyword(s):  
South Africa ◽  
Health Education ◽  
Pregnant Women ◽  
Health Information ◽  
Low Income ◽  
Information Needs ◽  
Antenatal Visit ◽  
Antenatal Clinics ◽  
Education Needs ◽  
Antenatal Visits

Health education is a key component of first antenatal visits. The aim of this study was to describe the health education needs of pregnant women on their first visit to antenatal clinics in Khayelitsha, South Africa. A quantitative descriptive survey was conducted, to investigate the lifestyle, pregnancy-related, psycho-social health education needs and predictors of health education needs during pregnant women’s first antenatal clinic visit. The research was conducted at two purposively selected antenatal clinics in Khayelitsha, a low-income suburb in Cape Town, South Africa. The respondents were considered eligible for the study if they were Xhosa speaking, pregnant, older than 18 years, making a first visit to antenatal care, and able to complete their consent form or provide consent from parents or relatives. Respondents were eligible for the study regardless of the number of pregnancies they had previously had, their age and previous medical conditions. There were a total of 240 (92%) respondents. Overall pregnancy-related health education needs were rated the highest (m=4.0, [95%CI3.95–4.09]), with information on how the baby grows and develops during pregnancy (m=4.6, [95%CI4.5–4.7]) the highest. The lowest rated health information needs were testing for HIV and prevention thereof (m=3.5, [95%CI3.3–3.7]) and how to use seat belts during pregnancy (m=3.2, [95%CI3.0–3.4]). A lack of awareness of the duration of pregnancy predicted significantly higher overall health education needs and lifestyle education needs. The study recommends that pregnant women should be provided with prioritised health information during their first antenatal visit, especially given the high risk of late bookings for first antenatal visits.

scholarly journals Association between sexual violence and unintended pregnancy among adolescent girls and young women in South Africa

2020 ◽  
Author(s):  
Anthony Idowu Ajayi ◽  
Henrietta Chinelo Ezegbe
Keyword(s):  
South Africa ◽  
Sexual Violence ◽  
Unintended Pregnancy ◽  
Adolescent Girls ◽  
Young Women ◽  
Teenage Pregnancy ◽  
Multivariable Analysis ◽  
Limited Attention ◽  
Cross Sectional ◽  
Unintended Pregnancies

Abstract Background Unintended pregnancy has dire consequences on the health and socio-economic wellbeing of adolescent girls and young women (AGYW) (aged 15-24 years). While most studies tend to focus on lack of access to contraceptive information and services, and poverty as the main contributing factor to early-unintended pregnancies, the influence of sexual violence has received limited attention. Understanding the link between sexual violence and unintended pregnancy is critical towards developing a multifaceted intervention to reduce unintended pregnancies among AGYW in South Africa, a country with high teenage pregnancy rates. MethodsDrawing from cross-sectional data obtained among AGYW in a South African university between June and November 2018, we estimated the magnitude of unintended pregnancy among AGYW and also examined the effect of sexual violence on unintended pregnancy. A final sample of 451 girls aged 17-24 years, selected using stratified sampling, were included in the analysis. We used adjusted and unadjusted logistic regression analysis to examine the effect of sexual violence on unintended pregnancy. ResultsThe analysis shows that 41.9% of all respondents had experienced an unintended pregnancy, and 25.9% of those unintended pregnancies ended in abortions. Unintended pregnancy was higher among survivors of sexual violence (54.4%) compared to those who never experienced sexual abuse (34.3%). In the multivariable analysis, sexual violence was consistently and robustly associated with increased odds of having an unintended pregnancy (AOR:1.70; 95% CI: 1.08-2.68).ConclusionAddressing unintended pregnancies among AGYW in South Africa requires interventions that not only increase access to contraceptive information and services but also reduce sexual violence and cater for survivors.

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