Prevalence and factors associated with dual contraception among women living with HIV/AIDS attending TASO Mulago HIV Clinic.

Abstract

Introduction: Dual contraception refers to use of condom concurrently with another effective contraceptive method to prevent unwanted pregnancies and sexually transmitted diseases including HIV. With advent of HAART, HIV positive patients live longer and fully exercise their sexual and reproductive health rights which exposes them to high risk of acquiring STIs and unwanted pregnancies. Persons living with HIV/AIDS do not consistently use condoms and women do not have negotiating power for condom use. Therefore dual contraception would be advisable in this population to prevent unwanted pregnancies and STIs including HIV. General objectives: To determine the prevalence and factors associated with dual contraception among women living with HIV attending TASO Mulago HIV clinic. Methods: This was a cross sectional study with a qualitative component. Quantitative methods were used to determine prevalence and factors associated with dual contraception while qualitative methods were used to establish attitudes and perceptions of women living with HIV towards dual contraception. Data management and analysis: Quantitative data was doubly entered into EpiData, checked for inconsistencies and exported to Stata version 12 for analysis. Qualitative data was recorded on tape recorder, transcribed verbatim, translated into English, analyzed with help of NVivo program using content analysis, codes categorized and categories grouped into subthemes and themes. Outcome: Proportion of women living with HIV using dual contraception and factors associated with dual contraception. Results: Out of 273 respondents 54 used dual contraception hence prevalence of 20.15%. At multivariate analysis, factors that were found independently associated with dual contraception were: spousal support, counselling, contraception and perceiving that there are adverse effects resulting from dual contraception. Qualitative data revealed that; respondents knew and acknowledged importance of dual contraception in prevention of STI and unwanted pregnancies but expressed fear of adverse effects and lack of male involvement. Conclusion: Prevalence of dual contraception was low (20.15%). Respondents expressed fear of adverse effects and lack of male involvement. It was recommended that proper counselling to dispel myths about adverse effects and male involvement be emphasized.