Acceptability and perceptions of contraceptives among young HIV positive women in KCCA Art Clinics

Abstract

Introduction There are about 7000 new HIV infections among young women in Sub Saharan Africa. Forty- three percent of pregnancies among young HIV positive women in Uganda are either unwanted or mistimed and this accounts for 21.3% of neonatal HIV infections. The prevention of unwanted pregnancy among young HIV positive women through the use of effective modern contraceptives is a key component of the WHO’s four-pronged HIV prevention and control strategy. Study objective. To determine the acceptability of contraceptives, its associated factors and perceptions of contraceptives among young HIV positive women in KCCA ART Clinics. Methods We conducted a convergent parallel mixed-methods study from February to May 2019 among 450 participants in three Public Kampala city HIV clinics (Kisenyi HC IV, Kiswa HC III and Komamboga HC III). For quantitative data, participants were systematically recruited into the study and were interviewed using a structured questionnaire. Data was analysed using STATA 13. Acceptability of contraceptives was measured by the proportion of participants that reported contraceptives to be very acceptable or acceptable. Prevalence ratios were determined using modified Poisson regression reporting clustered robust standard errors with a 95% confidence interval (CI) and P values. For qualitative data, six to eight participants were purposively selected from each facility for in-depth interviews. A total of 20 in-depth interviews were conducted from the three facilities. Thematic analysis was used to describe the data. Results The acceptability of contraceptives among young HIV positive women was low at 40.4 %( 95% CI: 26.0-54.9). Age greater than19 years (PR; 6.88, 95%CI; 1.09-46.91, P =0.04), having a friend who uses contraceptive (PR; 1.89, 95CI; 1.12-3.19; P=0.018) and being divorced/separated (PR; 1.31, 95%CI; 1.03-1.67, P=0,027) were found to be significantly associated with acceptability of contraceptives. Regarding perceptions themes that emerged misconceptions on contraceptive use, lived experiences and perceived negative interaction between ARVs and contraceptive. Conclusion Acceptability of contraceptives among young HIV positive in KCCA ART clinics was low and this could have been due to perceptions young women have about contraceptive usage. Young HIV positive women should be given more information on the safety of contraceptives use.