Risky sexual practice, unintended pregnancy, contraceptive utilisation, and its determinants among HIV-infected women in Special Zone of Oromia regional state, Ethiopia

Background: In settings where HIV prevalence is high, management of sexual and reproductive health is critical to reducing HIV transmission and maternal mortality. Integration of family planning with HIV services is appropriate model for HIV therapy, HIV prevention and care with family planning services in a resource limiting area like Ethiopia. The aims of the study were to determine risky sexual practice, unintended pregnancy, contraceptive utilisation, and its determinants among women of reproductive age in Oromia, Ethiopia Methods: A Health facility based cross-sectional study design was conducted with quantitative data collection approach was used to collect data from women living with HIV attending ART clinics in special zone of surrounding Finfinne, Oromia Region in five health centres. Simple random sampling computer-generated sample was used to select 654 respondents. The returned questionnaires were checked for completeness, cleaned manually, coded and entered into EPI INFO 7.1.6 version and exported to SPSSS 23.0 for further analysis. Bivariate and multivariable logistic regressions analysis was used to identify factors association with adjusted odds ratio (AOR) with 95% confidence interval (CI) to controlled effects of possible confounders from final model. Result: After discarded16 spoiled questionnaires, the completed response rate of this study was 97.6% (654/670). There were 654 respondents whose ages ranged between 18 and 49 years. The current family planning utilisation among women of reproductive age living with HIV was 548 (83.8%). The following were identified as determinants of current family planning among HIV-infected women in the area of study: open discussion on modern family planning utilisation with healthcare providers; being knowledgeable about modern family planning; number of sexual partners; previous unplanned pregnancy; partner’s HIV status; and disclosure status of HIV to their family. The last two factors led to higher odds of family planning utilisation among women of reproductive age living with HIV in Oromia Region.The study further established that contraception utilisation was influenced by the fact that 608 (94.9%) respondents were sexually active during the last six months. Disclosure of HIV status added to the list whereby 589 (91.4%) respondents had disclosed their HIV serostatus to a regular sexual partner and 499 (76.3%) had disclosed to family. The prevalence of dual contraceptive utilisation was 425 (73.8%), of which 343 (80.7%) and 306 (72%) were consistent and sustained users of dual contraceptive methods, respectively. The factors which were assumed to be increasing dual contraception method utilisation were: open discussion on family planning with healthcare providers; having received family planning counselling about the efficacy of each method and side effects and the mixed method available. Conclusion: The current family planning utilisation among women of reproductive age was higher than the national contraceptive prevalence rate. This proportion is parallel to the proportion of service providers reporting to provide both HIV- and family planning-related services as being largely dependent on training on integrated family planning and HIV services.

High level risky sexual behavior among persons living with HIV in the urban setting of the highest HIV prevalent areas in Ethiopia: Implications for interventions

Introduction Data on the sexual behavior among people living with human immunodeficiency virus (PLHIV) dwelling at HIV prevalent setting located at the periphery of Ethiopia is lacking. Therefore, this study was designed to investigate sexual practice of patients following their antiretroviral therapy (ART) service and factors affecting their behavior. Materials and methods A facility based cross-sectional study design was employed to assess risky sexual practice and associated factors among HIV positive adults attending ART clinics in Gambella town, Southwest Ethiopia. Risky sexual practice is defined as a custom of getting in at least one of the following practices such as condom-unprotected sex with any partner, having two or more sexual partners and practicing casual sex in the last three months. A total of 352 randomly selected clients were interviewed by using a structured questionnaire. The multivariable logistic regression model was used to examine the association between covariates and the outcome variable. Results Majority of the study participants were engaged at least in one of the risky sexual practices (79.8% confidence interval (CI): 75.3% - 83.9%). The multivariable analysis found that the odds of risky sexual practice were higher among individuals who use substances (‘khat’ users (AOR: 3.82, 95%CI:1.30–11.22), smoke cigarette (AOR:4.90, 95%CI:1.19–12.60), consume alcohol (AOR: 2.59, 95%CI:1.28–5.21)); those who never discuss about safe sex with their partner/s (AOR: 2.21, 95%CI:1.16–4.21); those who have been in attachment for longer duration (more than four years) with their partner (AOR: 3.56, 95%CI: 1.32–9.62); and groups who desire to bear children in their future life (AOR: 3.15, 95%CI:1.40–7.04) as compared to their respective comparison groups. Conclusions A significant number of participants were engaged at least in one of the risky sexual practices which potentially result in super infection by a new or/and drug resistant viral strain/s, and onward transmission of the virus. Thus, an HIV intervention program which focuses on the identified factors has to be implemented to mitigate risk of unsafe sexual behavior of this population group and move towards ending the HIV/Acquired Immunodeficiency Syndrome (AIDS) epidemic.