scholarly journals Socio-Cultural and Societal Demands Influencing Pregnancy among HIV Positive Women in Kakamega County, Kenya

2021 ◽  
Vol 3 (6) ◽  
pp. 31-38
Author(s):  
Isaac Maru ◽  
Rose Olayo ◽  
Mary Kipmerewo

Globally, the number of women living with HIV who desire pregnancy has been increasing and little is known as what motivates them, with test and treat women accessing ART desiring pregnancy will increase. Kakamega County has been leading in the region on women living with HIV accessing antenatal services. Past literature in the subject matter failed to look at socio-cultural and societal factors influencing pregnancy among HIV positive women in Kakamega County, Kenya; a gap that informed this study. A descriptive cross-sectional research design was employed. The target population were women aged 18-49 years receiving their family planning services in sub-county hospitals in Kakamega County. Key informants were made up of health care workers at comprehensive care clinics. Purposive sampling was used to select 4 sub-county hospitals, systematic random sampling to select 319 known HIV positive women and 4 focus group discussions. Questionnaires focused on group discussions and key informant interviews were used to collect data. Data collected were entered into Statistical Package for Social Sciences version 25.0. Descriptive results were presented in proportionate tables. The results showed that age, education, employment status and parity influenced the desire for pregnancy among HIV positive women in Kakamega County. Society influenced the number of children a woman should have. The community held a negative perception of childless women, especially HIV positive women; the community members did not attach value and pride over the childless HIV positive women. The socio-cultural and societal demand on HIV positive women influenced pregnancy; however, there decreasing association, which meant that the society was 71% less likely to influence the number of children; the spouse was 63% less likely to influence pregnancy. In conclusion, age, education level, marital status parity and employment status, medical cover influenced pregnancy among the known HIV positive women in Kakamega County. Socio-cultural and societal demands were predictors of pregnancy among known HIV positive women in Kakamega County. The community should treat HIV positive women with respect and dignity, thus permitting them to continue their family legacy and sire children. It recommends that there is a need for the county government, department of health services to provide health education to the community on stigma reduction and discrimination meted on these women and negative perception of childlessness women in the society especially known HIV positive women. Further works on the myths and misconception that barrenness is blamed on women leaving men scot-free for the cloud to be the culprits of childlessness in the family.

BMJ Open ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. e036391
Author(s):  
Tesfaye Regassa Feyissa ◽  
Melissa L. Harris ◽  
Peta M. Forder ◽  
Deborah Loxton

ObjectiveThis study aimed to examine fertility (live births) in the last 3 years and its associated factors among women living with HIV (WLHIV) in western Ethiopia .DesignParticipants were recruited into a cross-sectional survey using systematic sampling.SettingsFour healthcare facilities in western Ethiopia were included.ParticipantsEligible participants were WLHIV of reproductive age (15–49 years) from western Ethiopia who found out about their HIV-positive status more than 3 years ago (N=866).Primary outcome measuresThe fertility (live births) of HIV-positive women in the last 3 years was surveyed using face-to-face interviews (March–June 2018). Logistic regression analyses were conducted to examine factors influencing fertility in the last 3 years.ResultsA total of 108 (12.5%) HIV-positive women gave birth to 121 live children in the last 3 years. Of these births, 18.2% were reported as mistimed at conception, while 26.4% were reported as unwanted. Of the live births, 8.3% ended in death. Of the 76 (62.8%) children with known HIV status born to HIV-positive women in the last 3 years, 7.9% were HIV-positive. In terms of predictors of fertility, women aged 15–24 years (adjusted OR (AOR) 2.72; 95% CI 1.14 to 6.49) and 25–34 years (AOR 4.34; 95% CI 2.61 to 7.21) had increased odds of fertility compared with women aged 35–49 years. Women using antiretroviral therapy (ART) for less than 5 years were more likely to have given birth in the last 3 years compared with those using ART for 10 years or more (AOR 2.96; 95% CI 1.19 to 7.36), even after controlling for age.ConclusionsWLHIV in Ethiopia are having children and so it is imperative that safe conception strategies are readily available as well as support to reduce HIV-related risks for children born to these mothers. Strengthening reproductive health services for HIV-positive women in order to achieve their family planning goals is therefore important.


ISRN AIDS ◽  
2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
B. Unnikrishnan ◽  
Vinita Jagannath ◽  
John T. Ramapuram ◽  
B. Achappa ◽  
D. Madi

Background. Depression is one of the most prevalent psychiatric diagnoses seen in HIV-positive individuals. Women with HIV are about four times more likely to be depressed than those who are not infected. Aims. To assess the sociodemographic and clinical correlates of depression among women living with HIV/AIDS. Setting and Design. One public and one private hospital in Mangalore, Coastal South India, and cross-sectional design. Methods and Materials. Study constituted of 137 HIV-positive women, depression was assessed using BDI (Beck Depression Inventory), and social support was assessed using Lubben Social Network Scale. Statistical Analysis. All analysis was conducted using SPSS version 11.5. Chi-square test with value less than 0.05 was taken as statistically significant. Results. Among 137 HIV-positive women, 51.1% were depressed. Around 16% were having moderate to high risk for isolation. Depression was statistically significant in rural women, widowed women, and lower socioeconomic class women. Conclusion. Depression is highly prevalent among women living with HIV which is still underdiagnosed and undertreated, and there is a need to incorporate mental health services as an integral component of HIV care.


2018 ◽  
Vol 23 (4) ◽  
pp. 203
Author(s):  
Andi Nur Faizah

<p>The phenomenon of HIV-AIDS transmission places women in a difficult situation. The loss of family members such as husbands due to AIDS leaves women living with HIV positive in a struggle to access sources of livelihood. The condition of themselves as PLWHA, concerns about being stigmatized, caring for family members, and earning a living are the burdens of life they have to face. In this regard, this paper explores the complexity of the work of HIV-positive women. This study uses a qualitative method with a feminist perspective to get a complete picture of the livelihood of HIV-positive women. Based on interviews with five HIV-positive women, the findings found a link between social, identity, and gender categories that affect their livelihoods. HIV-positive women also transform themselves into their “normal” self by pretending to be healthy, able to work, have quality, and be independent. This is done as a form of resistance to the stigma attached to PLWHA.</p><p> </p><p> </p>


BMJ Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. e022221 ◽  
Author(s):  
Menkeoma Laura Okoli ◽  
Samuel Alao ◽  
Somtochukwu Ojukwu ◽  
Nnadozie C Emechebe ◽  
Asuelimen Ikhuoria ◽  
...  

BackgroundDespite the availability and knowledge of various contraceptive methods, consistent utilisation in women living with HIV/AIDS (WLWHA) within the reproductive age group remains below the Sustainable Development Goals (SDGs) and Family Planning 2020 goals. This study examines the association between sociodemographic factors and contraceptive use including the effect of clustering tendencies of these factors on contraceptive usage among WLWHA in Kenya.MethodsWeighted multivariate logistic regression models were conducted to determine the association of sociodemographic factors on contraception use among WLWHA using the 2008–2009 Kenya Demographic Health Survey. Spatial autocorrelation techniques were used to explore clustering tendencies of these factors on contraception utilisation. Our study population included 304 HIV positive women, aged 15–49 years.ResultsAmong 304 HIV-positive women in our study population, 92 (30.3%) reported using one method of contraception. Contraceptive use was significantly associated with wealth and education after adjustment for other sociodemographic variables. Women classified as having low and middle wealth index were less likely to use contraceptives (OR=0.17, 95% CI 0.07 to 0.43; OR=0.33, 95% CI 0.11 to 0.98, respectively) compared with women classified as having high wealth index. Similarly, women with primary education only were less likely to use contraceptives compared with women with secondary or higher education (OR=0.42, 95% CI 0.18 to 0.98). Spatial autocorrelation revealed significant positive clusters with weak clustering tendencies of non-contraceptive use among different levels of wealth index and education within different regions of Kenya.ConclusionThese findings underscores the need for intervention programmes to further target socially disadvantaged WLWHA, which is necessary for achieving the SDGs.


2020 ◽  
Vol 16 (1) ◽  
pp. 59-66
Author(s):  
Abdilahi Yousuf ◽  
Ramli Musa ◽  
Muhammad Lokman Md. Isa ◽  
Siti Roshaidai Mohd Arifin

Introduction: It has been found that HIV positive women are becoming increasingly affected by various illnesses, including Common Mental Disorders (CMDs) such as depression. Such comorbidity escalates the disease progression to the severe stage and commonly hinders treatment adherence. This study determined the prevalence of anxiety and depression amidst women living with HIV. Methods: Based on a cross-sectional and facility-based study, 357 HIV positive women were recruited using the systematic sampling technique from two public hospitals in Jijiga town, Ethiopia. The Hospital Anxiety and Depression Scale (HADS) was administered for screening, and followed by a pre-tested questionnaire that comprised of Perceived Social Support and HIV stigma. Results: The results revealed that the prevalence of both anxiety and depression amidst HIV positive women was 28.9% and 32.5%, respectively. In the multivariate analysis, it was discovered that lack of formal education, being divorced, unemployed, and earning a monthly income less than 1400 ETB (37.5 USD) were significantly associated with depression. Women with symptomatic HIV clinical stage III (AOR =2.06, 95% C.I (0.75-5.61), with CD4 cell count below 250 (AOR = 1.14, 95% C.I (0.57-2.28), and with co-infections (AOR= 1.04, 95% C.I (0.40-2.71) also suffered from depression. Conclusion: The study outcomes show that the prevalence of depression in women with HIV was 32.5%, but they were more likely to be depressed if they were illiterate, divorced, unemployed or had a financial burden. In addition, HIV positive women with less CD4 cell count and in the final clinical stage or suffered from a co-infection were also associated with depressive symptoms. This signifies the public health implications of psychological and cognitive morbidities of the illness among these women with chronic illnesses. Hence, future mental health interventions and HIV care should be integrated with substantial emphasis given to vulnerable groups, including HIV positive women.


2020 ◽  
Vol 2020 ◽  
pp. 1-12
Author(s):  
Getnet Gedefaw ◽  
Adam Wondmieneh ◽  
Asmamaw Demis

Background. Preventing unintended pregnancies among HIV positive women has a vital role to prevent mother to child transmission. Besides, increasing access to contraceptives has a number of economical importance and reducing the costs for mitigating the unintended pregnancy consequences. Therefore, this study is aimed at assessing the contraceptive use and method of preference among HIV positive women in Ethiopia. Methods. A systematic review and meta-analysis reporting guideline was applied. Articles searched from the Scopus, Pubmed/MEDLINE, EMBASE, AJOL, Hinari, and Google scholar were included in this review. The Stata 11 software was used to compute the analysis. Heterogeneity of the studies was detected using the Cochran Q test and I2 test statistics. Egger’s test was used to check the evidence of publication bias within the studies. Subgroup analysis and sensitivity analysis was computed with the evidence of heterogeneity. Results. Ten thousand one hundred twenty one (10121) women living with HIV/AIDS were recruited in this study. The national estimated prevalence of contraceptive use among HIV positive women in Ethiopia was 57.78% (95% CI: 48.53-67.03). Injectables and male condom were the most preferred contraceptives accounted for 36.00% (95% CI: 6.64-45.35) and 32.74% (95% CI: 21.08-44.40), respectively. Discussion with husband/partner (AOR: 4.70, 95% CI: 2.18-10.12), disclosure of HIV status to spouse/partner (AOR: 2.18, 95% CI: 1.55-3.06), ever counseled for modern contraceptives (AOR: 2.79, 95% CI: 2.01-3.88), attending secondary and above education (AOR: 3.12, 95% CI: 2.15-4.51), and having more than one live child (AOR: 2.61, 95% CI: 1.86-3.66) were increasing the likelihood of contraceptive use whereas not currently married women (AOR: 0.23, 95% CI: 0.16-0.34) was decreases the odds of contraceptive use. Conclusion. In Ethiopia, more than half of the women living with HIV/AIDS were using contraceptives. Discussion with husband/partner, disclosure of HIV status to spouse/partner, ever counseled for modern contraceptives, attending secondary and above education, and having more than one live child were increasing the uptake of contraceptives among HIV positive women. Partner discussion, having adequate information towards contraceptive use, and having desired number of child could increase the utilization; as a result, obstetric complication with HIV positive women due to unintended pregnancy is significantly decreasing.


2018 ◽  
Vol 49 (1) ◽  
pp. 26-31
Author(s):  
Temitope Omoladun Okunola ◽  
Kayode T Ijaduola ◽  
Ebunoluwa A Adejuyigbe

As mother-to-child transmission of HIV is difficult to predict and also hard to prevent in practice, pregnancy among women living with HIV/AIDS (WHA) needs to be taken with considerable aforethought. The prevention of unwanted pregnancy among WHA is therefore a public health issue. The aim of our study was to determine the unmet need for contraception among HIV-positive women and the associated factors. Ours was a cross-sectional study involving 425 non-pregnant WHA attending an adult HIV clinic in Nigeria. Interviewer-administered, structured questionnaires designed for the study were used to obtain data. The contraceptive uptake was 47% while the unmet need for contraception was 20%. There were significant associations between unmet need for contraception and age group ( P < 0.001), religion ( P < 0.001), ethnic group ( P < 0.001), knowledge about contraceptives ( P = 0.02), educational status ( P = 0.01) and partners’ retroviral status ( P = 0.008) The unmet need for contraception was high. Advocacy programs should perhaps be focused on older women, Christians and those with little or no education.


2017 ◽  
Vol 44 (1) ◽  
pp. 1.2-12 ◽  
Author(s):  
Lisa B Haddad ◽  
Jennifer H Tang ◽  
Jamie Krashin ◽  
Wingston Ng’ambi ◽  
Hannock Tweya ◽  
...  

BackgroundUnderstanding the influences on condom use among men and women living with HIV is critical to tailoring sexually transmitted infection/HIV prevention efforts.MethodsThis is a sub-analysis of a cross-sectional survey including 255 women and 220 men who were sexually active, HIV-positive, and attending HIV care visits in Lilongwe, Malawi. We estimated adjusted prevalence ratios (aPRs) to evaluate for factors associated with consistent condom use (always using condoms in the past month) and use at last coitus for men and women in separate models.ResultsAmong women: 38% and 55% reported consistent condom use and condom use at last coitus, respectively. For women, consistent use and use at last coitus were positively associated with the ability to refuse sex without condoms and shared decision-making compared with making the decision alone regarding condom use, and negatively associated with desire for children in the future. Consistent use also increased with longer antiretroviral therapy (ART) use (≥1 year compared with no ART use). Among men: 51% and 69% reported consistent condom use and condom use at last coitus, respectively. For men, the ability to refuse sex without condoms was associated with consistent use and use at last coitus, and believing that condoms should be used with other contraception was associated with consistent use.ConclusionsOur findings demonstrate ongoing low condom utilisation among HIV-positive individuals, and highlight that ART and contraceptive use do not deter condom use. Efforts to increase condom utilisation must recognise individual-level factors that influence use and should focus on relationship dynamics and promotion of empowerment and self-efficacy.


2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e17513-e17513
Author(s):  
Yinan Zheng ◽  
Jonah Musa ◽  
Brian Thomas Joyce ◽  
Jun Wang ◽  
Demirkan Gursel ◽  
...  

e17513 Background: Nigeria faces a high health burden of cervical cancer (CC), which is worsened by high prevalence of human immunodeficiency virus (HIV) infection. Repetitive elements (RE) are DNA sequences that occur in multiple copies throughout the human genome. HIV infection can lead to RE hypomethylation that causes genome instability, an event often seen in the early phase of tumorigenesis. We aim to examine global RE hypomethylation as a novel epigenetic biomarker for CC among HIV-positive women in Nigeria. Methods: This study involved three groups of women: a) HIV-positive with CC (n=39); b) HIV-positive and cancer-free (n=52); and c) HIV-negative with CC (n=23). We estimated three types of global RE methylation in cervical tissue using genome-wide methylation data: long interspersed nuclear elements (LINE-1), Alu, and human endogenous retrovirus (HERV). We used multiple linear regression adjusting for age, education, parity, employment, cancer stage, body mass index, and sample batch to compare the biomarkers across the HIV/ICC groups and paired t-test to compare 26 pairs of tumor vs. surrounding normal tissues, stratified by HIV status. Receiver operating characteristic curve (ROC) and area under the ROC (AUC) were used to examine the diagnostic value. Results: Among HIV-positive women, all 3 global RE methylation biomarkers were hypomethylated in CC compared to cancer-free (LINE-1: mean difference [MD]=-0.049, p-value=2.9e-8; Alu: MD=-0.011, p-value=2.0e-4; HERV: MD=-0.013, p-value=1.7e-6). Paired analyses showed a larger, more significant MD in HIV-positive stratum than HIV-negative, especially LINE-1 (MD=-0.048 vs. -0.020, p-value=0.004 vs. 0.254). LINE-1 achieved the highest AUC (0.85, 95% CI: 0.76-0.95) in distinguishing tumor tissue from normal tissue among HIV-positive women, followed by HERV (0.82, 95% CI: 0.73-0.92) and Alu (0.60, 95% CI: 0.47-0.72). Conclusions: Global LINE-1 hypomethylation may serve as a novel biomarker for CC screening and early detection for women living with HIV in low- and middle-income countries.


Author(s):  
Celeste Watkins-Hayes

Previous literature suggests that AIDS Service Organizations (ASOs) play an important support role in the lives of impoverished women living with HIV. Less is known about the dynamics of institutional support for middle-class women living with HIV/AIDS, who are assumed to possess a broader base of resources to address their diagnosis. Using qualitative data collected from a racially and economically diverse group of HIV-positive women in Chicago, this article compares how low-income and middle-class women utilize ASOs and reveals how the women’s divergent approaches to availing themselves of institutional resources have important implications for their social and economic coping. For example, associating with ASOs can be status-improving for impoverished women and status-diminishing for middle-class women. As a result, middle-class women report a less robust network of social service providers and people living with HIV/AIDS on whom they rely for HIV-related information and social support, making them vulnerable to HIV-specific social isolation. In sum, the ways that HIV-positive women deploy institutional ties to negotiate their HIV/AIDS status differs markedly depending on socioeconomic status, suggesting that the role of class in gathering social support may be more complex than previously understood.


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