Contraceptive use and unmet need for family planning among HIV-positive women: A hospital-based study

SummaryIn Lesotho, the risk of mother-to-child-transmission (MTCT) of HIV is substantial; women of childbearing age have a high HIV prevalence rate (26·4%), low knowledge of HIV status and a total fertility rate of 3·5 births per woman. An effective means of preventing MTCT is to reduce unwanted fertility. This paper examines the unmet need for contraception to limit and space births among HIV-positive women in Lesotho aged 15–49 years, using the 2004 Lesotho Demographic and Health Survey. HIV-positive women have their need for contraception unmet in almost one-third of cases, and multivariate analysis reveals this unmet need is most likely amongst the poor and amongst those not approving of family planning. Urgent action is needed to lower the level of unmet need and reduce MTCT. A constructive strategy is to improve access to family planning for all women in Lesotho, irrespective of HIV status, and, more specifically, integrate family planning with MTCT prevention and voluntary counselling and testing services.

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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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Predictors of Unmet Need for Family Planning among HIV Positive Women in Care in Federal Teaching Hospital Gombe, Nigeria

Asian Journal of Medicine and Health ◽

10.9734/ajmah/2020/v18i330191 ◽

2020 ◽

pp. 26-33

Author(s):

A. Mohammed ◽

D. Chiroma ◽

C. H. Laima ◽

M. A. Danimoh ◽

P. A. Odunze

Keyword(s):

Family Planning ◽

Unmet Need ◽

Hiv Care ◽

Hiv Positive ◽

P Value ◽

Mother To Child Transmission ◽

Child Transmission ◽

Hiv Positive Women ◽

History Of ◽

Mother To Child

Background: Elimination of mother-to-child transmission (EMTCT) of Human Immunodeficiency Virus (HIV) requires adequate and continuous use of family planning commodities among women of reproductive age. This can be made possible by reducing the proportion of HIV positive women with unmet need for family planning. The study aims to determine the factors associated with having unmet need among women in HIV care. Methods: A cross sectional study was conducted using an interviewer administered questionnaire to study 325 women on HIV care. Cluster sampling technique was used to select the study respondents from the clinic. Results: Less than half of the respondents (40%) were currently using family planning, 35% had unmet need for family planning with 53.6% having unmet need for spacing while 46.4% having unmet need for limiting. Women with no history of previous use of family planning were fifteen times more likely to have unmet need for family planning than those with history of previous use of family planning (p value <0.001, CI 2.511-15.770). Also women with more than five deliveries were eight times more likely to have unmet need for family planning (p value 0.004, CI 0.001-0.279) while women with 2-5 deliveries are four times likely to have unmet need for family planning (p value 0.035, CI 0.005-0.832). Conclusion: A high proportion of women receiving ART care still have unmet need for family planning despite incorporating this service in HIV care. It is therefore important to target high risk groups to reduce the proportion of women with unmet need for family planning which will invariable reduce mother to child transmission of HIV.

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Unmet need for family planning and associated factors among married women attending anti-retroviral treatment clinics in Dire Dawa City, Eastern Ethiopia

PLoS ONE ◽

10.1371/journal.pone.0250297 ◽

2021 ◽

Vol 16 (4) ◽

pp. e0250297

Author(s):

Hiwot Dejene ◽

Muluemebet Abera ◽

Afework Tadele

Keyword(s):

Decision Making ◽

Family Planning ◽

Associated Factors ◽

Unmet Need ◽

Married Women ◽

Hiv Positive ◽

Cross Sectional ◽

Eastern Ethiopia ◽

Hiv Positive Women ◽

Dire Dawa

Background Unmet need for family planning is a measure of the gap between women’s contraceptive behavior and their fertility desires. It should be measured among different population groups to effectively implement public health interventions. Thus, this study aimed to determine the magnitude of unmet need for family planning and associated factors among HIV- positive women in Dire Dawa city Anti-retroviral treatment (ART) clinics, Eastern Ethiopia. Methods We carried out a facility-based cross-sectional study (March-June 2020) among 409 married women aged 15–49 on ART, using systematic random sampling. A face-to-face interview was done using a structured questionnaire. Bivariable and multivariable logistic regression was done to identify factors associated with unmet need for family planning. Results Overall, 33% [95% confidence interval (CI): 28.9–37.9] of the respondents had unmet need for family planning. Woman’s residing in a rural area (adjusted odds ratio (AOR): 2.41 [95% CI: 1.24–4.67]), woman’s not attained formal education (AOR: 4.14 [95% CI: 1.73–9.93]) and attaining primary education (AOR: 2.97 [95% CI: 1.54–5.74]), poor knowledge (AOR: 2.87 [95% CI: 1.52–5.40]), and unfavorable attitude towards family planning (AOR: 2.21 [95% CI: 1.12–4.34]), clients not satisfied with family planning service (AOR: 6.34 [95% CI: 3.31–12.15]), the woman not having decision making power on family planning (AOR:3.97 [95% CI: 2.14–7.38]) and not getting family planning counseling in ART clinics (AOR: 2.87 [95% CI: 1.54–5.35]) were positively associated with having unmet need for family planning. Conclusion This study indicates there a high unmet need for family planning among married HIV-positive women. Factors like a place of residence, educational status of women, knowledge and attitude towards family planning, client satisfaction with FP service, women decision-making power, and FP counseling service in ART. Therefore, we recommend that the concerned bodies should collaborate with ART clinics to design interventions that enhance access to family planning programs to combat the high unmet need for family planning among HIV-positive women.

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Assessing Reproductive Decision-making Among HIV-Positive Women in Kumasi, Ghana

International Journal of MCH and AIDS (IJMA) ◽

10.21106/ijma.274 ◽

2019 ◽

Vol 8 (1) ◽

pp. 54-62

Author(s):

Alicia E. Hersey ◽

Betty Norman ◽

Rebecca Reece

Keyword(s):

Decision Making ◽

Family Planning ◽

Unmet Need ◽

Hiv Positive ◽

Hiv Status ◽

Reproductive Decision ◽

Hiv Positive Women ◽

Reproductive Decision Making ◽

Unmet Need For Contraception ◽

Hiv Negative

Background or Objectives: HIV-positive women have higher rates of unmet need for contraception and unintended pregnancy and face unique obstacles in accessing family planning services, such as healthcare- related stigma and disclosing HIV status to partners. This study characterizes factors that influence the reproductive decision-making of women living with HIV and identifies areas for improvement in reproductive counseling in Kumasi. Methods: In this cross-sectional study, HIV-positive women, ages 18 to 45 years, presenting for care at Komfo Anokye Teaching Hospital between June and August 2017 were interviewed using structured surveys. Information gathered included demographics, method of contraceptive use, initiation of anti- retroviral therapy (ART), knowledge and use of contraception, and future reproductive plans. The primary outcome was current family planning use and future reproductive desire. Univariate analysis was used to characterize the demographics of the study group. Bivariate analysis including Chi-squared test was employed to assess the association between use of family planning between women with an HIV-positive and HIV-negative partner, with significance set at p < 0.05. Results: A total of 88 women were interviewed. The unmet need for contraception was 10%. Among all sexually active women, 26% did not use contraception. Fewer women with HIV-negative or untested partners were using contraception (65% and 67%, respectively), compared to women with HIV-positive partners (93%). Partner preference was the most common reason cited for not using a method of contraceptive (46%). Similar trends were found in future reproductive desires based on age cohorts, partner status, and use of family planning. Conclusion and Global Health Implications: Significant barriers to family planning use among HIV- positive women remain, especially those with a serodiscordant partner. Most partners were aware of their partner’s HIV status. This highlights an important opportunity to include partners in HIV and contraceptive counseling. Key words: • HIV • Family planning • Contraception • LARC • Serodiscordant • Ghana • Africa Copyright © 2019 Hersey et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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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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O729 High unmet need for contraception and unplanned pregnancy among HIV positive women - Call to intergrate family planning into post natal and HIV treatment clinics

International Journal of Gynecology & Obstetrics ◽

10.1016/s0020-7292(09)61102-4 ◽

2009 ◽

Vol 107 ◽

pp. S302-S302

Author(s):

T. Oyebode ◽

S. Sagay ◽

J. Musa ◽

C. Ekwempu ◽

W. Sanni

Keyword(s):

Family Planning ◽

Unplanned Pregnancy ◽

Unmet Need ◽

Hiv Treatment ◽

Hiv Positive ◽

Hiv Positive Women ◽

Unmet Need For Contraception

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Overcoming Barriers to Family Planning through Integration: Perspectives of HIV-Positive Men in Nyanza Province, Kenya

AIDS Research and Treatment ◽

10.1155/2013/861983 ◽

2013 ◽

Vol 2013 ◽

pp. 1-8 ◽

Cited By ~ 9

Author(s):

Rachel L. Steinfeld ◽

Sara J. Newmann ◽

Maricianah Onono ◽

Craig R. Cohen ◽

Elizabeth A. Bukusi ◽

...

Keyword(s):

Family Planning ◽

Unmet Need ◽

Male Involvement ◽

Hiv Positive ◽

Structural Barriers ◽

Nyanza Province ◽

Hiv Positive Women ◽

Family Planning Counseling ◽

Planning Methods ◽

Hiv Positive Men

This study explored barriers to and facilitators of using family planning services among HIV-positive men in Nyanza Province, Kenya. From May to June 2010, in-depth interviews were conducted with 30 men receiving care at 15 HIV clinics. The key barriers to the use of family planning included concerns about side effects of contraceptives, lack of knowledge about contraceptive methods, myths and misconceptions including fear of infertility, structural barriers such as staffing shortages at HIV clinics, and a lack of male focus in family planning methods and service delivery. The integration of family planning into HIV clinics including family planning counseling and education was cited as an important strategy to improve family planning receptivity among men. Integrating family planning into HIV services is a promising strategy to facilitate male involvement in family planning. Integration needs to be rigorously evaluated in order to measure its impact on unmet need for contraception among HIV-positive women and their partners and assure that it is implemented in a manner that engages both men and women.

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The Level of Unmet Need for Family Planning and Its Predictors among HIV-Positive Women in Ethiopia: A Systematic Review and Meta-Analysis

BioMed Research International ◽

10.1155/2021/3139272 ◽

2021 ◽

Vol 2021 ◽

pp. 1-11

Author(s):

Maru Mekie ◽

Dagne Addisu ◽

Wubet Taklual ◽

Abenezer Melkie

Keyword(s):

Systematic Review ◽

Family Planning ◽

Quality Assessment ◽

Digital Libraries ◽

Meta Analysis ◽

Information Access ◽

Unmet Need ◽

Hiv Positive ◽

Human Immuno Deficiency Virus ◽

Hiv Positive Women

Background. Studies indicated that the need for family planning appears to be greater for human immuno-deficiency virus- (HIV-) positive women than the general population to reduce the risk of pediatrics HIV infection and related consequences of unintended pregnancy. We aimed to assess the level of unmet need for family planning and its predictors among HIV-positive women in Ethiopia. Methods. Online databases such as PubMed, SCOPUS, EMBASE, HINARI, Google Scholar, and digital libraries of universities were used to search for studies to be included in this systematic review and meta-analysis. Quality assessment of included studies was conducted using the Newcastle-Ottawa Quality Assessment Scale (NOS). Data were extracted using the format prepared on Excel workbook and analyzed by the Stata 11 software. Cochran ( Q test) and I 2 test statistics were used to assess the heterogeneity of studies. Similarly, the funnel plot and Egger’s regression asymmetry test were used to assess publication bias. Result. This systematic review and meta-analysis was conducted using nine primary studies with a total of 6,154 participants. The pooled prevalence of unmet need for family planning among HIV-positive women was found to be 25.72% (95% CI: 21.63%, 29.81%). Participants age 15-24 years (( OR = 3.12 ; 95% CI: 1.59, 6.11) I 2 = 27.5 %; p = 0.252 ), being illiterate (( OR = 2.69 ; 95% CI: 1.69, 4.26) I 2 = 0.0 % ; p = 0.899 ), failure to discuss FP with partner (( OR = 3.38 ; 95% CI: 2.20, 5.18) I 2 = 0.0 %; p = 0.861 ), and no access to family planning information (( OR = 4.70 ; 95% CI: 2.83, 7.81) I 2 = 0.0 %; p = 0.993 ) were found to be a significant predictors of unmet need for family planning among HIV-positive women. Conclusion. The level of unmet need for family planning among HIV-positive women was found to be high in Ethiopia. Being young age, illiteracy, failed to discuss family planning issues with a partner, and no access to family planning information were found to be the significant predictors of unmet need for family planning among HIV-positive women in Ethiopia. Improving information access and encouraging partners’ involvement in family planning counseling and services could reduce the level of unmet need for family planning.

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