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Published in: BMC Public Health 1/2014

Open Access 01-12-2014 | Research article

Family planning practice and predictors of risk of inconsistent condom use among HIV-positive women on anti-retroviral therapy in Cambodia

Authors: Naomi Nakaie, Sovanna Tuon, Ikuma Nozaki, Fuzuki Yamaguchi, Yuri Sasaki, Kazuhiro Kakimoto

Published in: BMC Public Health | Issue 1/2014

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Abstract

Background

In Cambodia, while anti-retroviral therapy (ART) services are increasingly available, the unmet needs of family planning among general population are high. These facts raise concern on possible exposure of many HIV-positive women on ART to the potential risk of unintended pregnancy. This study aimed to clarify family planning practices in Cambodia and determine predictors of risk of inconsistent condom use among women on ART.

Methods

A cross-sectional survey with a structured questionnaire was conducted at five government-run health centers in Phnom Penh, Cambodia, from June to September, 2012. Multiple logistic regression analysis was used to identify predictors of risk of inconsistent condom use among regular users of contraceptive methods.

Results

Of 408 respondents, 40, 17 and 10 used the pill, IUD, and injection, respectively, while 193 used condoms. 374 were not planning to have a child. Among 238 sexually active women who were not planning to have a baby, 59 were exposed to the risk of unintended pregnancy. Multivariate logistic regression analysis that did not include variables related to partners identified "seeking family planning information" (adjusted odds ratio (AOR): 2.6, 95% confidence intervals (95% CI): 1.1-6.2), awareness of mother-to-child transmission (MTCT) (AOR: 4.7, 95% CI: 1.9-11.6) and "having a son" (AOR: 2.0, 95% CI: 1.1-3.9) were significant predictors of inconsistent condom use. Another model that included all variables identified “able to ask a partner to use condom at every sexual intercourse” was the only predictor (AOR: 23.7, 95% CI: 5.8-97.6).

Conclusions

About one-quarter of women on ART are at risk to unintended pregnancy although most do not plan to get pregnant. Furthermore, women on ART could be more empowered through improvement of communication and negotiation skills with partners to demand the use of condom during sexual intercourse. The use of other contraceptive methods that do not need partner involvement should be promoted.
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Literature
3.
go back to reference Homsy J, Bunnell R, Moore D, King R, Malamba S, Nakityo R, Glidden D, Tappero J, Mermin J: Reproductive intentions and outcomes among women on antiretroviral therapy in rural Uganda: a prospective cohort study. PLoS One. 2009, 4: e4149-10.1371/journal.pone.0004149.CrossRefPubMedPubMedCentral Homsy J, Bunnell R, Moore D, King R, Malamba S, Nakityo R, Glidden D, Tappero J, Mermin J: Reproductive intentions and outcomes among women on antiretroviral therapy in rural Uganda: a prospective cohort study. PLoS One. 2009, 4: e4149-10.1371/journal.pone.0004149.CrossRefPubMedPubMedCentral
4.
go back to reference King R, Khana K, Nakayiwa S, Katuntu D, Homsy J, Bunnell R: ‘Pregnancy comes accidentally-like it did with me’: reproductive decisions among women on ART and their partners in rural Uganda. BMC Public Health. 2011, 11: 530-10.1186/1471-2458-11-530.CrossRefPubMedPubMedCentral King R, Khana K, Nakayiwa S, Katuntu D, Homsy J, Bunnell R: ‘Pregnancy comes accidentally-like it did with me’: reproductive decisions among women on ART and their partners in rural Uganda. BMC Public Health. 2011, 11: 530-10.1186/1471-2458-11-530.CrossRefPubMedPubMedCentral
5.
go back to reference Myer L, Carter RJ, Katyal M, Toro P, El-Sadr WM, Abrams EJ: Impact of antiretroviral therapy on incidence of pregnancy among HIV-infected women in Sub-Saharan Africa: a cohort study. PLoS Med. 2010, 7: e1000229-10.1371/journal.pmed.1000229.CrossRefPubMedPubMedCentral Myer L, Carter RJ, Katyal M, Toro P, El-Sadr WM, Abrams EJ: Impact of antiretroviral therapy on incidence of pregnancy among HIV-infected women in Sub-Saharan Africa: a cohort study. PLoS Med. 2010, 7: e1000229-10.1371/journal.pmed.1000229.CrossRefPubMedPubMedCentral
6.
go back to reference Schwartz SR, Rees H, Mehta S, Venter WD, Taha TE, Black V: High incidence of unplanned pregnancy after antiretroviral therapy initiation: findings from a prospective cohort study in South Africa. PLoS One. 2012, 7: e36039-10.1371/journal.pone.0036039.CrossRefPubMedPubMedCentral Schwartz SR, Rees H, Mehta S, Venter WD, Taha TE, Black V: High incidence of unplanned pregnancy after antiretroviral therapy initiation: findings from a prospective cohort study in South Africa. PLoS One. 2012, 7: e36039-10.1371/journal.pone.0036039.CrossRefPubMedPubMedCentral
7.
go back to reference Kanniappan S, Jeyapaul MJ, Kalyanwala S: Desire for motherhood: exploring HIV- positive women’s desires, intentions and decision-making in attaining motherhood. AIDS Care. 2008, 20: 625-630. 10.1080/09540120701660361.CrossRefPubMed Kanniappan S, Jeyapaul MJ, Kalyanwala S: Desire for motherhood: exploring HIV- positive women’s desires, intentions and decision-making in attaining motherhood. AIDS Care. 2008, 20: 625-630. 10.1080/09540120701660361.CrossRefPubMed
11.
go back to reference Sathiarany V, Kanal K, Nakaie N, Kakimoto K: Scaling Up of the National Programme for the Prevention of Mother-To-Child Transmission (PMTCT) of HIV in Cambodia. 2011, Busan, Korea: The l0th ICAAP Sathiarany V, Kanal K, Nakaie N, Kakimoto K: Scaling Up of the National Programme for the Prevention of Mother-To-Child Transmission (PMTCT) of HIV in Cambodia. 2011, Busan, Korea: The l0th ICAAP
12.
go back to reference Areechokchai D, Bowonwatanuwong C, Phonrat B, Pitisuttithum P, Maek-A-Nantawat W: Pregnancy outcomes among HIV-infected women undergoing antiretroviral therapy. Open Aids J. 2009, 3: 8-13. 10.2174/1874613600903010008.CrossRefPubMedPubMedCentral Areechokchai D, Bowonwatanuwong C, Phonrat B, Pitisuttithum P, Maek-A-Nantawat W: Pregnancy outcomes among HIV-infected women undergoing antiretroviral therapy. Open Aids J. 2009, 3: 8-13. 10.2174/1874613600903010008.CrossRefPubMedPubMedCentral
13.
go back to reference Webb S, Holman D: A survey of contraceptive use and unplanned pregnancy in Perth, Western Australia. Aust J Public Health. 1992, 16: 382-386.CrossRefPubMed Webb S, Holman D: A survey of contraceptive use and unplanned pregnancy in Perth, Western Australia. Aust J Public Health. 1992, 16: 382-386.CrossRefPubMed
15.
go back to reference Cooper D, Harries J, Myer L, Orner P, Bracken H, Zweigenthal V: “Life is still going on”: reproductive intentions among HIV-positive women and men in South Africa. Soc Sci Med. 2007, 65: 274-283. 10.1016/j.socscimed.2007.03.019.CrossRefPubMed Cooper D, Harries J, Myer L, Orner P, Bracken H, Zweigenthal V: “Life is still going on”: reproductive intentions among HIV-positive women and men in South Africa. Soc Sci Med. 2007, 65: 274-283. 10.1016/j.socscimed.2007.03.019.CrossRefPubMed
16.
17.
go back to reference Oosterhoff P, Anh NT, Hanh NT, Yen PN, Wright P, Hardon A: Holding the line: family responses to pregnancy and the desire for a child in the context of HIV in Vietnam. Cult Health Sex. 2008, 10: 403-416. 10.1080/13691050801915192.CrossRefPubMed Oosterhoff P, Anh NT, Hanh NT, Yen PN, Wright P, Hardon A: Holding the line: family responses to pregnancy and the desire for a child in the context of HIV in Vietnam. Cult Health Sex. 2008, 10: 403-416. 10.1080/13691050801915192.CrossRefPubMed
19.
go back to reference Beyeza-Kashesya J, Kaharuza F, Mirembe F, Neema S, Ekstrom AM, Kulane A: The dilemma of safe sex and having children: challenges facing HIV sero-discordant couples in Uganda. Afr Health Sci. 2009, 9: 2-12.PubMedPubMedCentral Beyeza-Kashesya J, Kaharuza F, Mirembe F, Neema S, Ekstrom AM, Kulane A: The dilemma of safe sex and having children: challenges facing HIV sero-discordant couples in Uganda. Afr Health Sci. 2009, 9: 2-12.PubMedPubMedCentral
20.
go back to reference Kikuchi K, Wakasugi N, Poudel KC, Sakisaka K, Jimba M: High rate of unintended pregnancies after knowing of HIV infection among HIV positive women under antiretroviral treatment in Kigali, Rwanda. Biosci Trends. 2011, 5: 255-263.CrossRefPubMed Kikuchi K, Wakasugi N, Poudel KC, Sakisaka K, Jimba M: High rate of unintended pregnancies after knowing of HIV infection among HIV positive women under antiretroviral treatment in Kigali, Rwanda. Biosci Trends. 2011, 5: 255-263.CrossRefPubMed
21.
go back to reference Wongboonsin K, Ruffolo VP: Sex preference for children in Thailand and some other South-East Asian countries. Asia Pac Popul J. 1995, 10: 43-62.PubMed Wongboonsin K, Ruffolo VP: Sex preference for children in Thailand and some other South-East Asian countries. Asia Pac Popul J. 1995, 10: 43-62.PubMed
22.
go back to reference Jayaraman A, Mishra V, Arnold F: The relationship of family size and composition to fertility desires, contraceptive adoption and method choice in South Asia. Int Perspect Sex Reprod Health. 2009, 35: 29-38. 10.1363/3502909.CrossRefPubMed Jayaraman A, Mishra V, Arnold F: The relationship of family size and composition to fertility desires, contraceptive adoption and method choice in South Asia. Int Perspect Sex Reprod Health. 2009, 35: 29-38. 10.1363/3502909.CrossRefPubMed
23.
go back to reference Kamal SM, Islam MA: Interspousal communication on family planning and its effect on contraceptive adoption in Bangladesh. Asia Pac J Public Health. 2012, 24: 506-521. 10.1177/1010539511399118.CrossRefPubMed Kamal SM, Islam MA: Interspousal communication on family planning and its effect on contraceptive adoption in Bangladesh. Asia Pac J Public Health. 2012, 24: 506-521. 10.1177/1010539511399118.CrossRefPubMed
24.
go back to reference Miller JE, Rodgers YV: Mother’s education and children’s nutritional status: new evidence from Cambodia. Asian Dev Rev. 2009, 26: 131-165. Miller JE, Rodgers YV: Mother’s education and children’s nutritional status: new evidence from Cambodia. Asian Dev Rev. 2009, 26: 131-165.
26.
go back to reference Anupama KM: Gendered epidemic: addressing the specific needs of women fighting HIV/AIDS in Cambodia. Berkeley Women’s Law J. 2003, 18: 254-264. Anupama KM: Gendered epidemic: addressing the specific needs of women fighting HIV/AIDS in Cambodia. Berkeley Women’s Law J. 2003, 18: 254-264.
27.
go back to reference Samandari G, Ilene S, O’Connell K: The role of social support and parity on contraceptive use in Cambodia. Int Perspect Sex Reprod Health. 2010, 36: 122-131. 10.1363/3612210.CrossRefPubMed Samandari G, Ilene S, O’Connell K: The role of social support and parity on contraceptive use in Cambodia. Int Perspect Sex Reprod Health. 2010, 36: 122-131. 10.1363/3612210.CrossRefPubMed
28.
go back to reference Couture MC, Sansothy N, Sapphon V, Phal S, Sichan K, Stein E, Evans J, Maher L, Kaldor J, Vun MC, Page K: Young women engaged in sex work in Phnom Penh, Cambodia, have high incidence of HIV and sexually transmitted infections, and amphetamine type stimulant use: new challenges to HIV prevention and risk. Sex Transm Dis. 2011, 38: 33-39. 10.1097/OLQ.0b013e3182000e47.CrossRefPubMedPubMedCentral Couture MC, Sansothy N, Sapphon V, Phal S, Sichan K, Stein E, Evans J, Maher L, Kaldor J, Vun MC, Page K: Young women engaged in sex work in Phnom Penh, Cambodia, have high incidence of HIV and sexually transmitted infections, and amphetamine type stimulant use: new challenges to HIV prevention and risk. Sex Transm Dis. 2011, 38: 33-39. 10.1097/OLQ.0b013e3182000e47.CrossRefPubMedPubMedCentral
29.
go back to reference Beyeza-Kashesya J, Kaharuza F, Ekstrom AM, Neema S, Kulane A, Mirembe F: To use or not to use a condom A prospective cohort study comparing contraceptive practices among HIV-infected and HIV-negative youth in Uganda. BMC Infect Dis. 2011, 11: 144-10.1186/1471-2334-11-144.CrossRefPubMedPubMedCentral Beyeza-Kashesya J, Kaharuza F, Ekstrom AM, Neema S, Kulane A, Mirembe F: To use or not to use a condom A prospective cohort study comparing contraceptive practices among HIV-infected and HIV-negative youth in Uganda. BMC Infect Dis. 2011, 11: 144-10.1186/1471-2334-11-144.CrossRefPubMedPubMedCentral
Metadata
Title
Family planning practice and predictors of risk of inconsistent condom use among HIV-positive women on anti-retroviral therapy in Cambodia
Authors
Naomi Nakaie
Sovanna Tuon
Ikuma Nozaki
Fuzuki Yamaguchi
Yuri Sasaki
Kazuhiro Kakimoto
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2014
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-14-170

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