Demand for long acting and permanent contraceptive methods and associated factors among female antiretroviral treatment attendees in Addis Ababa, Ethiopia
No Thumbnail Available
Date
2014-07
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Addis Abeba Universty
Abstract
Background: Unmet need for family planning is similar sometimes even higher among women
living with HIV. There is also a significant number of unintended pregnancies ranging from 51
percent to 84% among HIV-positive women. In Ethiopia, the prevalence rate of LAPMs among
the general population has shown an increment. The use of implant recently has increased from
12% to 16%.
Objectives: The objective of this study is to assess the demand for long acting and permanent
contraceptive method and factors associate with it among HIV-positive women enrolled on
antiretroviral treatment program in public hospitals in Addis Ababa, Ethiopia.
Methods: A facility based mixed methods research combining quantitative cross sectional study
design and qualitative research was carried out in Addis Ababa among HIV-positive women
initiated ART. A sample size of 421 was calculated and distributed to the selected hospitals
based on the number of ART clients each have. A structured and pre- tested questionnaire was
used to collect the data. Data collection was under taken from March2- April 20 2014 for both
qualitative and quantitative study. The qualitative study was conducted in the same hospitals.
Binary logistic regression and multivariate analysis were employed using SPSS version 21.
Result: A total of 394 HIV positive women who initiated ART were included on the study with
the response rate of 93.6%. The total demand for LAPMs among HIV positive women on ART
was 60.2% (95% CI 55-65) which was 14% for met need and 46.2% unmet need. Factors
associated with demand for LAPMS were number of live children (AOR 0.188 95% CI 0.074-
0.476) and disclosure of HIV status to family members (AOR 0.400 95% CI 0.227-0.750).
Number of live children (AOR 0.100 95% CI 0.032-0.311), marital status (AOR 0.405 95% CI
0.169-0.968, disclosure of HIV status to family members (AOR 0.339 95% CI 0.182-0.631) and
satisfaction with cost of method (AOR 0.438 95% CI 0.221-0.867) were predictors of unmet
need. The qualitative study findings also supported the above result where the participants
explained that family members usually interfere in the women’s decision to use LAPMs.
Conclusion and recommendation: The study shows the high total demand and unmet need for
LAPMs, which may increase the mother to child HIV transmission due to unintended
pregnancies caused by the failure of other short acting methods. Unmet need for LAPMs of
contraception can be addressed by proper training of service providers (Both ART and FP),
better counseling skill on family planning and proper management of side effects.
Description
Keywords
Demand for long acting