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|Title: ||Unmet Reproductive Health Care Needs and Occurrence of Unintended Pregnancy among HIV Positive Women in Antiretroviral Treatment Units in Addis Ababa, Ethiopia|
|Authors: ||Girum, Zewdu|
|Advisors: ||Alemayehu Mekonen (MD, MPH|
Mulugeta Betre (MD, MPH)
|Keywords: ||HIV Positive Women|
|Copyright: ||Apr-2011 |
|Date Added: ||4-May-2012 |
|Abstract: ||Back ground: Reproductive health issues appear to be relatively neglected among HIV positive
women. Hence the contribution of contraception as a strategy to reduce mother-to-child
transmission is underutilized. As well, there are few incites and substantive data on the magnitude
of unmet reproductive health care needs and occurrence of unintended pregnancy among HIV
positive women is not available in Ethiopia (Addis Ababa).
Objective of the study: This study assessed unmet reproductive health care needs and
occurrence of unintended pregnancy among HIV positive women enrolled in the ART units.
Methodology: The study was undertaken from December 2010 to Feburary2011 using
quantitative cross sectional facility based study supplemented by qualitative in-depth interview on
a sample of 548 HIV positive women in the ART follow up units in Addis Ababa. A systematic
random sampling procedure was applied to select study participants. A pretested structured
questioner was used to collect data and the data was analyzed using SPSS version 11.
Result: Unmet need for contraception in the study was 31%: 25% for spacing and 6% for
limiting. Generally, HIV positive women who had a higher chance of unmet need for
contraception were those with sero discordant partner (adjusted OR: 2.4, 95%CI: 1.04-5.64) and
women who had faced unintended pregnancy after being HIV positive (adjusted OR: 10.12,
95%CI: 4.6-22.3). Whereas, women with recent CD4 count >200 were less likely to have unmet
need for contraception than CD4 count of ≤ 200 (adjusted OR: 0.257, 95% CI: 0.09-0.70).
The proportion of unintended pregnancies among the total pregnancies during the post HIV
diagnosis period were 147 (46%); of which 125 (38%) mistimed and 22 (8%) unwanted. In a
multivariate analysis, HIV positive women who have unmet contraceptive (adjusted OR: 14.9,
95%CI: 4.8-46) and those who had ever used emergency contraception (adjusted OR: 4.1,
95%CI: 2-9.2) were having a significantly higher chance of experiencing unintended pregnancy.
11% of the women had ever discussed emergency contraception and discussion of safe
termination of pregnancy was (8%) with the provider while contraception and condom were most
discussed with the provider as reported by 78% of the respondents. Unmet need for safe
termination of pregnancy was 37%.
Conclusion: Unmet contraceptive need and of reproductive counseling and safe termination of
pregnancy were high among HIV positive women in the ART units. As a major manifestation of
these, occurrence of unintended pregnancy was significantly higher among HIV positive women
in the ART care units in Addis Ababa; which has implications for vertical HIV transmition. These
indicating the need to sought new strategies to address reproductive health care services and
hence to satisfy reproductive health care needs of HIV positive woman.|
|Appears in:||Thesis - Public Health|
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