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BMC Women's Health
Published in: BMC Women's Health 1/2018

Open Access 01-12-2018 | Research article

Facing HIV infection and unintended pregnancy: Rakai, Uganda, 2001–2013

Authors: Stephanie Ann Grilo, Xiaoyu Song, Tom Lutalo, Margo Mullinax, Sanyukta Mathur, John Santelli

Published in: BMC Women's Health | Issue 1/2018

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Abstract

Background

Unintended pregnancy is a persistent and global issue with consequences for the health and well-being of mothers and babies. The aim of this paper is to examine unintended pregnancy over time in the context of substantial human immunodeficiency virus (HIV) prevalence and increasing access to anti-retro viral therapy (ART).

Method

Data are from the Rakai Community Cohort Study (RCCS) – a cohort of communities with 10,000–12,000 adults, ages 15–49, in Rakai District, Uganda. We examined prevalence of current pregnancies over time, intended pregnancy, and unintended pregnancies (unwanted, mistimed, ambivalent). We then examined risk factors for the different categories of unintended pregnancy among women who were currently pregnant. The full sample included 32,205 observations over 13 years.

Results

The prevalence of mistimed pregnancy and unwanted pregnancy both decreased significantly over time (p < .001). The prevalence of current pregnancies and intended pregnancy showed no significant changes over the thirteen year period. The same overall pattern was found when only examining HIV positive women in the sample; however, the trends were not significant. Out of the 2820 current pregnancies reported, 54.4% were intended, 29.8% were mistimed, 13.2% were unwanted, and 2.5% were ambivalent. After controlling for other predictors, HIV status had no independent effect on mistimed pregnancy but had a significant effect on unwanted pregnancy (RRR = 2.44, 95% CI = 1.65–3.61, p < .001] and ambivalent pregnancy [RRR = 2.07; CI: 1.03 to 4.18, p = 0.041]. In 2004, after the introduction of ART, there was a decreased risk in unintended pregnancy [RR = 0.75; CI: 0.66 to 0.84, p < .001]. Women with a secondary education or higher also had a decreased risk in unintended pregnancy [RR = 0.70; CI: 0.70 to 0.92, p = 0.002].

Discussion

HIV was an important predictor of unwanted pregnancy. Unintended pregnancy decreased in the sample over time which may be due to an increase in ART availability and rising levels of education.
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Metadata
Title
Facing HIV infection and unintended pregnancy: Rakai, Uganda, 2001–2013
Authors
Stephanie Ann Grilo
Xiaoyu Song
Tom Lutalo
Margo Mullinax
Sanyukta Mathur
John Santelli
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Women's Health / Issue 1/2018
Electronic ISSN: 1472-6874
DOI
https://doi.org/10.1186/s12905-018-0535-y

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