Contraceptive utilization and associated factors among HIV positive women in Mulago Hospital ISS Clinic

Abstract

Introduction: Although HIV prevalence in Uganda has reduced from over 30% in the early 1980s to 6.4% in 2006, many people still suffer from HIV and many more are still getting infected with the disease. For the unborn child, spread through MTCT is still the main route of transmission. However despite this, the Contraceptive Prevalence Rate is still low (23.7%) and has not increased over the years. Contraceptive use is important in the prevention of pregnancy and considering the increased risks associated with pregnancy in HIV, HIV positive women should be utilizing contraceptive.

Objective: The study aimed at determining the contraceptive utilization among HIV positive women in Mulago ISS clinic and the associate factors.

Methodology: A cross sectional study was carried out at the Mulago ISS clinic in Kampala district. Systematic sampling was used to select women to participate in the study. A total of 330 women who meet the inclusion criteria were interviewed using an interviewer administered questionnaire between February and March 2009. Qualitative data was collected using FGDs. Data was then analyzed using SPSS 12. Logistic regression was used for the quantitative data. Qualitative data was analyzed according to the emerging themes.

Results: From the study, Contraceptive Prevalence Rate among all the women in the study was 60% and 70% among the married compared to 48% among the unmarried. The most commonly used methods included the male condom (41.4%), Injectables (38.9%) and Pills (13.69%). Among the factors associated with contraceptive utilization included intention to have children (OR=57.50, CI: 7.09-46.23) and marital status (OR= 5.61, CI: 2.14-14.73). Duration on ARV was found to be confounding the relationship between Contraceptive utilization and intention to have children in the future (43.9%). Desire for children was found to be highest among those who were newly married. In addition, discontinuation of contraceptives was mainly because of the side effects associated with the different contraceptive methods.

Conclusion: Women with HIV infection like other women may wish to plan pregnancy, limit their family or avoid pregnancy. It is therefore important to take into consideration their desires in order for them to make informed reproductive choices especially concerning use of contraceptives. More still, those who do not wish to have any more children should be encouraged to consider more long term methods like male and female sterilization and stick to consistent and correct condom use.