Unintended Repeat Pregnancies Among HIV Positive Women in Rio De Janeiro, Brazil

Introduction: High rates of unintended pregnancies among HIV positive women have been reported by several studies. Among repeated pregnancies, these rates may be higher. Our aim was to describe the unintended pregnancy rate in repeat gestations of the same group of HIV-positive women. Methodology: From a prospective cohort of HIV-infected pregnant women followed-up from 1995 to 2013 in an Antenatal Clinic (ANC) in Rio de Janeiro, we selected women who had at least two consecutive pregnancies. Patient data were prospectively obtained from standardized questionnaires. The main dependent variable was if the pregnancy was intended or unintended. Some of the other variables were: age, the interval between pregnancies, household income, CD4 cells count at admission in the ANC and at delivery, viral load<1000 copies/ml at admission and close to delivery, and attempts to illegal abortion. Results: From a total of 287 women included, the number of unintended pregnancies increased from 138 (63.6%) at first pregnancy to 198 (81.8%) at second pregnancy (p < 0.01). At first pregnancy, we observed 8 women who had made an attempt to illegal abortion (7 with an unintended pregnancy and 1 with a wanted pregnancy, p = 0.06), while at second pregnancy, 34 of them had made an attempt (33 with unintended pregnancy and 1 with a wanted pregnancy, p < 0.01). Regarding viral load suppression close to delivery, there was no statistic difference between first and second pregnancies (72,7% vs. 70,5%, p = 0.36) as well as between intended and unintended pregnancies (in first pregnancy: 80% vs. 86%, p = 0.4; in second pregnancy: 72% vs. 83%, p = 0,1). Conclusion: High rates of unintended pregnancies and illegal abortion attempts, along with their increase from one pregnancy to the subsequent, reinforce the need for continuous family planning practices in HIV-infected patients. The majority of the women were able to reach undetectable viral load at the end of the pregnancy, including those with unintended pregnancies. Implications: HIV infected patients presenting in antenatal care for sequential unintended pregnancies. Despite the fact that abortion is illegal in this country, a substantial number of women, still attempt it before attending antenatal care. Family planning actions should be performed during the antenatal care.

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Postpartum Contraceptive Use Among HIV Positive Women in Cipto Mangunkusumo Hospital Jakarta, Indonesia: A Cross Sectional Study

KnE Medicine ◽

10.18502/kme.v1i1.552 ◽

2016 ◽

Vol 1 (1) ◽

Author(s):

Merry Amelya

Keyword(s):

Family Planning ◽

Unintended Pregnancy ◽

Contraceptive Use ◽

Elective Caesarean Section ◽

Hiv Positive ◽

Potential Contribution ◽

Original Cohort ◽

Unintended Pregnancies ◽

Hiv Positive Women ◽

Long Acting

Background: Prevention of unintended pregnancy among HIV positive women is the second element of prevention of mother to child transmission of HIV. Contraceptive use in Indonesia remains low, despite the potential contribution of family planning (FP) to the prevention of HIV infection and unintended pregnancy. It is anticipated that this research will update existing knowledge, inform policy makers and programmers to support safer and healthier reproductive options among HIV positive women in the study area.Methods: The study was conducted in Cipto Mangunkusumo Hospital Jakarta, Indonesia, since January 1st 2013 until December 31st 2014. Of the original cohort of 5499 women delivered in 2013-2014, 65 were HIV positive. The 58 subjects in this study were selected from each group of HIV positive women and HIV negative who had delivery in this hospital either by emergency admission or elective caesarean section. Results: There were a total of 5449 deliveries, during the study period, out of which 65 were HIV positive women (1,2%). From 58 randomly selected patients, the mean age of HIV positive mothers was 27,74 ± 4,73 years. Their parity ranged from zero to five. With significantly uses of long acting contraception as IUD and sterilization on HIV-positive women as well as booked cased patients.Conclusions: The high rates of unintended pregnancies in the sample of HIV positive women suggest that the WHO’s strategy of preventing unintended pregnancies amongst HIV positive women to minimise vertical transmission of HIV must be reinforced. Long acting and permanent methods could fill an important gap in family planning services in Indonesia given women’s stated fertility preferences indicating a strong desire to either not have a future pregnancy or to wait several years before the birth of their next child.

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Fertility preferences, unintended pregnancy and contraceptive use among HIV-positive women desiring family planning in Lilongwe, Malawi

Contraception ◽

10.1016/j.contraception.2011.05.087 ◽

2011 ◽

Vol 84 (3) ◽

pp. 325 ◽

Cited By ~ 3

Author(s):

L. Haddad ◽

S. Phiri ◽

C. Cwiak ◽

C. Feldacker ◽

M. Hosseinipour ◽

...

Keyword(s):

Family Planning ◽

Unintended Pregnancy ◽

Contraceptive Use ◽

Hiv Positive ◽

Fertility Preferences ◽

Hiv Positive Women

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Missed Opportunities for Family Planning Counselling among HIV-Positive Women Receiving HIV Care in Uganda

10.21203/rs.2.16340/v1 ◽

2019 ◽

Author(s):

JULIET NABIRYE ◽

Joseph KB Matovu ◽

John Baptist Bwanika ◽

Fredrick Makumbi ◽

Rhoda K. Wanyenze

Keyword(s):

Family Planning ◽

Reproductive Health ◽

Critical Time ◽

Hiv Care ◽

Hiv Positive ◽

Cross Sectional Survey ◽

Time Points ◽

Modern Contraception ◽

Unintended Pregnancies ◽

Hiv Positive Women

Abstract Introduction HIV-positive women who are still in the reproductive years need adequate sexual and reproductive health information to make informed reproductive health choices. However, many HIV-positive women who interface with the health system continue to miss out on this information. We sought to: a) determine the proportion of HIV-positive women enrolled in HIV care who missed family planning (FP) counselling; and b) assess if any association existed between FP counseling and current use of modern contraception to inform programming.Methods Data were drawn from a quantitative national cross-sectional survey of 5,198 HIV-positive women receiving HIV care at 245 HIV clinics in Uganda; conducted between August and November 2016. Family planning counseling was defined as receipt of FP information by an HIV-positive woman during ANC, at the time of delivery or at the PNC visit. Analyses on receipt of FP counseling were done on 2,760 HIV-positive women aged 15-49 years who were not currently pregnant and did not intend to have children in the future. We used a modified Poisson regression model to determine the Prevalence Ratio (PR) as a measure of association between receipt of any FP counseling and current use of modern contraception, controlling for potential confounders. Analyses were performed using STATA statistical software, version 14.1.Results Overall, 2,104 (76.2%) HIV-positive women reported that they received FP counseling at any of the three critical time-points. Of the 24% ( n =656) who did not, 37.9% missed FP counseling at ANC; 41% missed FP counseling during delivery; while 54% missed FP counseling at the post-natal care visit. HIV-positive women who received any FP counseling were significantly more likely to report current use of modern contraception than those who did not (adjusted PR [adj. PR] = 1.21; 95% Confidence Interval [CI]: 1.10, 1.33).Conclusion Nearly one-quarter of HIV-positive women did not receive any form of FP counseling when they interfaced with the healthcare system. This presents a missed opportunity for prevention of unintended pregnancies, and suggests a need for the integration of FP counseling into HIV care at all critical time-points.

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Missed Opportunities for Family Planning Counselling among HIV-Positive Women Receiving HIV Care in Uganda

10.21203/rs.2.16340/v2 ◽

2020 ◽

Author(s):

JULIET NABIRYE ◽

Joseph KB Matovu ◽

John Baptist Bwanika ◽

Fredrick Makumbi ◽

Rhoda K. Wanyenze

Keyword(s):

Family Planning ◽

Reproductive Health ◽

Critical Time ◽

Hiv Care ◽

Hiv Positive ◽

Cross Sectional Survey ◽

Time Points ◽

Modern Contraception ◽

Unintended Pregnancies ◽

Hiv Positive Women

Abstract Introduction HIV-positive women who are still in the reproductive years need adequate sexual and reproductive health information to make informed reproductive health choices. However, many HIV-positive women who interface with the health system continue to miss out on this information. We sought to: a) determine the proportion of HIV-positive women enrolled in HIV care who missed family planning (FP) counselling; and b) assess if any association existed between FP counseling and current use of modern contraception to inform programming. Methods Data were drawn from a quantitative national cross-sectional survey of 5,198 HIV-positive women receiving HIV care at 245 HIV clinics in Uganda; conducted between August and November 2016. Family planning counseling was defined as receipt of FP information by an HIV-positive woman during ANC, at the time of delivery or at the PNC visit. Analyses on receipt of FP counseling were done on 2,760 HIV-positive women aged 15-49 years who were not currently pregnant and did not intend to have children in the future. We used a modified Poisson regression model to determine the Prevalence Ratio (PR) as a measure of association between receipt of any FP counseling and current use of modern contraception, controlling for potential confounders. Analyses were performed using STATA statistical software, version 14.1. Results Overall, 2,104 (76.2%) HIV-positive women reported that they received FP counseling at any of the three critical time-points. Of the 24% ( n =656) who did not, 37.9% missed FP counseling at ANC; 41% missed FP counseling during delivery; while 54% missed FP counseling at the post-natal care visit. HIV-positive women who received any FP counseling were significantly more likely to report current use of modern contraception than those who did not (adjusted PR [adj. PR] = 1.21; 95% Confidence Interval [CI]: 1.10, 1.33). Conclusion Nearly one-quarter of HIV-positive women did not receive any form of FP counseling when they interfaced with the healthcare system. This presents a missed opportunity for prevention of unintended pregnancies, and suggests a need for the integration of FP counseling into HIV care at all critical time-points.

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Missed Opportunities for Family Planning Counselling among HIV-Positive Women Receiving HIV Care in Uganda

10.21203/rs.2.16340/v3 ◽

2020 ◽

Author(s):

JULIET NABIRYE(Former Corresponding Author) ◽

Joseph KB Matovu(New Corresponding Author) ◽

John Baptist Bwanika ◽

Fredrick Makumbi ◽

Rhoda K. Wanyenze

Keyword(s):

Family Planning ◽

Reproductive Health ◽

Critical Time ◽

Hiv Care ◽

Hiv Positive ◽

Cross Sectional Survey ◽

Time Points ◽

Modern Contraception ◽

Unintended Pregnancies ◽

Hiv Positive Women

Abstract Introduction HIV-positive women who are still in the reproductive years need adequate sexual and reproductive health information to make informed reproductive health choices. However, many HIV-positive women who interface with the health system continue to miss out on this information. We sought to: a) determine the proportion of HIV-positive women enrolled in HIV care who missed family planning (FP) counselling; and b) assess if any association existed between FP counseling and current use of modern contraception to inform programming. Methods Data were drawn from a quantitative national cross-sectional survey of 5,198 HIV-positive women receiving HIV care at 245 HIV clinics in Uganda; conducted between August and November 2016. Family planning counseling was defined as receipt of FP information by an HIV-positive woman during ANC, at the time of delivery or at the PNC visit. Analyses on receipt of FP counseling were done on 2,760 HIV-positive women aged 15-49 years who were not currently pregnant and did not intend to have children in the future. We used a modified Poisson regression model to determine the Prevalence Ratio (PR) as a measure of association between receipt of any FP counseling and current use of modern contraception, controlling for potential confounders. Analyses were performed using STATA statistical software, version 14.1. Results Overall, 2,104 (76.2%) HIV-positive women reported that they received FP counseling at any of the three critical time-points. Of the 24% ( n =656) who did not, 37.9% missed FP counseling at ANC; 41% missed FP counseling during delivery; while 54% missed FP counseling at the post-natal care visit. HIV-positive women who received any FP counseling were significantly more likely to report current use of modern contraception than those who did not (adjusted PR [adj. PR] = 1.21; 95% Confidence Interval [CI]: 1.10, 1.33). Conclusion Nearly one-quarter of HIV-positive women did not receive any form of FP counseling when they interfaced with the healthcare system. This presents a missed opportunity for prevention of unintended pregnancies, and suggests a need for the integration of FP counseling into HIV care at all critical time-points.

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Family planning and PMTCT services: Examining interrelationships, strengthening linkages

10.31899/hiv2003.1006 ◽

2003 ◽

Keyword(s):

Family Planning ◽

Hiv Transmission ◽

Hiv Positive ◽

Number Of Children ◽

Voluntary Counseling And Testing ◽

Unintended Pregnancies ◽

Hiv Positive Women ◽

Counseling And Testing ◽

Pregnancy And Lactation ◽

Mother To Child

Preventing unintended pregnancy among HIV-positive women through family planning (FP) services is one of the four cornerstones of a comprehensive program for prevention of mother-to-child HIV transmission (PMTCT). Reducing unintended pregnancies among HIV-positive women would yield a reduction in infections among infants and a reduction in the number of children potentially orphaned when parents die of AIDS-related illnesses. It also reduces HIV-positive women's vulnerability to morbidity and mortality related to pregnancy and lactation. In addition, family planning for both HIV-positive and -negative women safeguards their health by enabling them to space births. This brief focuses on findings from Horizons studies on the extent to which voluntary counseling and testing (VCT) and PMTCT programs address family planning. In Kenya and Zambia, the Horizons Program collaborated with NARESA and the MTCT Working Group, respectively, and UNICEF to document the acceptability, operational barriers, costs, and impact of pilot PMTCT services.

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Missed Opportunities for Family Planning Counselling among HIV-Positive Women Receiving HIV Care in Uganda

10.21203/rs.2.16340/v4 ◽

2020 ◽

Author(s):

JULIET NABIRYE(Former Corresponding Author) ◽

Joseph KB Matovu(New Corresponding Author) ◽

John Baptist Bwanika ◽

Fredrick Makumbi ◽

Rhoda K. Wanyenze

Keyword(s):

Family Planning ◽

Reproductive Health ◽

Critical Time ◽

Hiv Care ◽

Hiv Positive ◽

Cross Sectional Survey ◽

Time Points ◽

Modern Contraception ◽

Unintended Pregnancies ◽

Hiv Positive Women

Abstract Introduction: HIV-positive women who are still in the reproductive years need adequate sexual and reproductive health information to make informed reproductive health choices. However, many HIV-positive women who interface with the health system continue to miss out on this information. We sought to: a) determine the proportion of HIV-positive women enrolled in HIV care who missed family planning (FP) counselling; and b) assess if any association existed between receipt of FP counselling and current use of modern contraception to inform programming. Methods: Data were drawn from a quantitative national cross-sectional survey of 5,198 HIV-positive women receiving HIV care at 245 HIV clinics in Uganda; conducted between August and November 2016. Family planning counselling was defined as provision of FP information (i.e. available FP methods and choices) to an HIV-positive woman by a health provider during ANC, at the time of delivery or at the PNC visit. Analyses on receipt of FP counselling were done on 2,760 HIV-positive women aged 15-49 years who were not currently pregnant and did not intend to have children in the future. We used a modified Poisson regression model to determine the Prevalence Ratio (PR) as a measure of association between receipt of any FP counselling and current use of modern contraception, controlling for potential confounders. Analyses were performed using STATA statistical software, version 14.1.Results: Overall, 2,104 (76.2%) HIV-positive women reported that they received FP counselling at any of the three critical time-points. Of the 24% (n=656) who did not, 37.9% missed FP counselling at ANC; 41% missed FP counselling during delivery; while 54% missed FP counselling at the post-natal care visit. HIV-positive women who received any FP counselling were significantly more likely to report current use of modern contraception than those who did not (adjusted PR [adj. PR] = 1.21; 95% Confidence Interval [CI]: 1.10, 1.33). Conclusion: Nearly one-quarter of HIV-positive women did not receive any form of FP counselling when they interfaced with the healthcare system. This presents a missed opportunity for prevention of unintended pregnancies, and suggests a need for the integration of FP counselling into HIV care at all critical time-points.

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