Modern contraceptive uptake and associated factors among hiv positive women attending Soroti Hospital, Uganda

Abstract

Introduction: In SSA about 60% of PHAs are reproductive age women. HIV+ women continue to have unplanned pregnancies due to low uptake of MFP methods. Unplanned pregnancies among PHAs are associated with increased paediatric HIV transmission and poor maternal health. Objective: This study assessed awareness of and attitude on modern family planning use, determined modern family planning methods used and associated factors among HIV+ women attending Soroti hospital. Methodology: This was a cross sectional study conducted between April and June 2014. It employed both quantitative and qualitative data collection methods. Quantitative data was collected from 265 participants using semi structured questionnaires while qualitative data was collected from 18 purposively selected HIV positive women using in-depth interviews and from 5 health workers using key informant interviews .Among the HIV positive women interviewed 9 were currently using modern family planning and the rest were not Data analysis: Univariate analysis was used to describe the study population, bivariate and multivariate logistic regression were used to identify factors independently associated with current modern family planning use. Qualitative data was analyzed manually using thematic content analysis. Results: The median age for the respondents was 29 (IQR: 25 -34) years. Awareness of at least one modern family planning (MFP) method was 85.1%, information on dual contraception method was 52.8% and 59.1% level of positive attitude towards MFP use. Overall contraceptive prevalence rate for MFP among sexually active was 64.3%, methods used included; Condoms only (15%), dual method (16.5%), Injectable (23.7%), implant (16.5%), IUDs (18%), Pills 7.9%and bilateral tubal ligation (2.2%). At multivariate analysis factors independently associated with MFP use were; awareness of dual contraception (adj OR 9.45 (1.81-49.3) P=0.008), positive attitude towards MFP (adj OR 42.01(11.86-57.75) P = 0.001), plan or desire for children in future (adj OR 8.64 (1.23-60.28) P= 0.030) and Marital status adj OR 0.01(0.003-0.12) P=0.003.Qualitative interview revealed awareness about MFP, lack of knowledge on suitable MFP methods, fear of side effects and xiii

uncertainty about safety of methods, family and Gender relations and MFP service delivery as factors for MFP use. Conclusion: Although knowledge on MFP methods was high, their uptake was moderate and there was low uptake for dual contraception method that is advocated for among HIV positive women. Recommendation: There is need implement approaches for improving dual contraception uptake, increasing partner support and to avail suitable MFP service delivery rooms.