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Published in: BMC Women's Health 1/2014

Open Access 01-12-2014 | Research article

Contraceptive use and unmet need for family planning among HIV positive women on antiretroviral therapy in Kumasi, Ghana

Authors: Dennis Odai Laryea, Yaw Ampem Amoako, Kathryn Spangenberg, Ebenezer Frimpong, Judith Kyei-Ansong

Published in: BMC Women's Health | Issue 1/2014

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Abstract

Background

A key strategy for minimizing HIV infection rates especially via reduction of Mother– to-Child transmission is by reducing the unmet need for family planning. In Ghana, the integration of family planning services into Antiretroviral Therapy services for persons living with HIV/AIDS has largely been ignored. We set out to measure the prevalence of modern methods of contraception, the unmet need for family planning and to identify factors associated with the use of modern methods of contraception among HIV positive women on anti retroviral therapy.

Methods

This was a descriptive cross sectional study of HIV positive women in their reproductive ages accessing care at an adult Antiretroviral Therapy Clinic in Kumasi, Ghana. Data was collected using a structured questionnaire. Data analysis was conducted using Epi Info version 7.1.2.0.

Results

A total of 230 women were included in the study. Fifty six percent were in the 30–39 year age group. The mean age (SD) was 36.3 (5.4) years. While 53.5% of respondents desired to have children, partner desire for children was reported by 54.6% of respondents with partners. About 74% had received information on contraception from their provider. 42.6% of participants and/or their partners were using a contraception method at the time of study; the male condom (79.6%) being the most commonly used method. The estimated unmet need for contraception was 27.8%. Contraceptive use was strongly associated with partner knowledge of HIV status (AOR = 3.64; 95% CI 1.36–9.72; p = 0.01) and use of a contraceptive method prior to diagnosis of HIV (AOR = 6.1; 2.65–14.23; p < 0.001).

Conclusion

Contraceptive Prevalence is high among HIV positive women in Kumasi compared with the general Ghanaian population. Despite this, there still is a high unmet need for family planning in this population. We recommend continuous education on contraceptives use to HIV patients accessing HAART services to further increase contraceptive uptake.
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Literature
1.
go back to reference United Nations: The Millennium Development Goals Report 2013. 2013, New York: United Nations United Nations: The Millennium Development Goals Report 2013. 2013, New York: United Nations
2.
go back to reference United Nations: Global Report: UNAIDS Report on the Global AIDS Epidemic 2010. United Nations Program on AIDS. 2010, Geneva, Switzerland: United Nations Program on AIDS United Nations: Global Report: UNAIDS Report on the Global AIDS Epidemic 2010. United Nations Program on AIDS. 2010, Geneva, Switzerland: United Nations Program on AIDS
3.
go back to reference World Health Organisation: Global Update on HIV Treatment 2013: Results, Impact and Opportunities. 2013, Geneva, Switzerland: World Health Organisation World Health Organisation: Global Update on HIV Treatment 2013: Results, Impact and Opportunities. 2013, Geneva, Switzerland: World Health Organisation
4.
go back to reference National AIDS/STI Control Programme: Annual Report 2011. 2012, Accra: Ministry of Health/Ghana Health Service National AIDS/STI Control Programme: Annual Report 2011. 2012, Accra: Ministry of Health/Ghana Health Service
5.
go back to reference National AIDS/STI Control Programme: Guidelines for Antiretroviral Therapy in Ghana. 2010, Accra: Ministry of Health/Ghana Health Service National AIDS/STI Control Programme: Guidelines for Antiretroviral Therapy in Ghana. 2010, Accra: Ministry of Health/Ghana Health Service
6.
go back to reference Kavanaugh M, Anderson R: Contraception and Beyond: The Health Benefits of Services Provided at Family Planning Centers. 2013, New York: Guttmacher Institute Kavanaugh M, Anderson R: Contraception and Beyond: The Health Benefits of Services Provided at Family Planning Centers. 2013, New York: Guttmacher Institute
8.
go back to reference Ghana Statistical Service: Ghana Demographic and Health Survey 2008. 2009, Accra, Ghana: GSS, GHS and ICF Macro Ghana Statistical Service: Ghana Demographic and Health Survey 2008. 2009, Accra, Ghana: GSS, GHS and ICF Macro
13.
go back to reference Cates W, Steiner M: Dual protection against unintended pregnancy and sexually transmitted infections - what is the best contraceptive approach?. Sex Transm Dis. 2002, 29 (3): 168-174. 10.1097/00007435-200203000-00007.CrossRefPubMed Cates W, Steiner M: Dual protection against unintended pregnancy and sexually transmitted infections - what is the best contraceptive approach?. Sex Transm Dis. 2002, 29 (3): 168-174. 10.1097/00007435-200203000-00007.CrossRefPubMed
14.
go back to reference Centers for Disease Control and Prevention (CDC): Update: barrier protection against HIV infection and other sexually transmitted diseases. Morb Mortal Wkly Rep. 1993, 42 (30): 589-591. Centers for Disease Control and Prevention (CDC): Update: barrier protection against HIV infection and other sexually transmitted diseases. Morb Mortal Wkly Rep. 1993, 42 (30): 589-591.
15.
go back to reference Heikinheimo O, Lähteenmäki P: Contraception and HIV infection in women. Hum Reprod Update. 2009, 15 (2): 165-176.CrossRefPubMed Heikinheimo O, Lähteenmäki P: Contraception and HIV infection in women. Hum Reprod Update. 2009, 15 (2): 165-176.CrossRefPubMed
16.
go back to reference Schwartz SR, Rees H, Mehta S, Venter WDF, 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 (4): e36039-10.1371/journal.pone.0036039.CrossRefPubMedPubMedCentral Schwartz SR, Rees H, Mehta S, Venter WDF, 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 (4): e36039-10.1371/journal.pone.0036039.CrossRefPubMedPubMedCentral
17.
go back to reference Walusimbi J, Birabwa E, Nabankema E, AnneMarie A, Lutalo I, Nakiwooga A: Pregnancy decisions and contraceptive use among HIV-positive women: a study in a large urban clinic in sub-Saharan Africa. J Int AIDS Soc. 2010, 13 (Suppl 4): 164-10.1186/1758-2652-13-S4-P164.CrossRef Walusimbi J, Birabwa E, Nabankema E, AnneMarie A, Lutalo I, Nakiwooga A: Pregnancy decisions and contraceptive use among HIV-positive women: a study in a large urban clinic in sub-Saharan Africa. J Int AIDS Soc. 2010, 13 (Suppl 4): 164-10.1186/1758-2652-13-S4-P164.CrossRef
18.
go back to reference Kakaire O, Osinde MO, Kaye DK: Factors that predict fertility desires for people living with HIV infection at a support and treatment centre in Kabale, Uganda. Reprod Health. 2010, 7: 27-10.1186/1742-4755-7-27.CrossRefPubMedPubMedCentral Kakaire O, Osinde MO, Kaye DK: Factors that predict fertility desires for people living with HIV infection at a support and treatment centre in Kabale, Uganda. Reprod Health. 2010, 7: 27-10.1186/1742-4755-7-27.CrossRefPubMedPubMedCentral
20.
21.
go back to reference Kipp W, Heys J, Jhangri GS, Alibhai A, Rubaale T: Impact of antiretroviral therapy on fertility desires among HIV-infected persons in rural Uganda. Reprod Health. 2011, 8 (1): 27-10.1186/1742-4755-8-27.CrossRefPubMedPubMedCentral Kipp W, Heys J, Jhangri GS, Alibhai A, Rubaale T: Impact of antiretroviral therapy on fertility desires among HIV-infected persons in rural Uganda. Reprod Health. 2011, 8 (1): 27-10.1186/1742-4755-8-27.CrossRefPubMedPubMedCentral
22.
go back to reference Stanwood NL, Cohn SE, Heiser JR, Pugliese M: Contraception and fertility plans in a cohort of HIV-positive women in care. Contraception. 2007, 75 (4): 294-298. 10.1016/j.contraception.2006.12.012.CrossRefPubMedPubMedCentral Stanwood NL, Cohn SE, Heiser JR, Pugliese M: Contraception and fertility plans in a cohort of HIV-positive women in care. Contraception. 2007, 75 (4): 294-298. 10.1016/j.contraception.2006.12.012.CrossRefPubMedPubMedCentral
23.
go back to reference Massad LS, Evans CT, Wilson TE, Golub ET, Sanchez-Keeland L, Minkoff H, Weber K, Watts DH: Contraceptive use among U.S. women with HIV. J Womens Health. 2007, 16 (5): 657-666. 10.1089/jwh.2006.0204.CrossRef Massad LS, Evans CT, Wilson TE, Golub ET, Sanchez-Keeland L, Minkoff H, Weber K, Watts DH: Contraceptive use among U.S. women with HIV. J Womens Health. 2007, 16 (5): 657-666. 10.1089/jwh.2006.0204.CrossRef
24.
go back to reference Ghana Statistical Service: 2010 Population & Housing Census Summary Report of Final Results. 2012, Accra: Ministry of Finance Ghana Statistical Service: 2010 Population & Housing Census Summary Report of Final Results. 2012, Accra: Ministry of Finance
25.
go back to reference Oladapo OT, Daniel OJ, Odusoga OL, Ayoola-Sotubo O: Fertility desires and intentions of HIV-positive patients at a suburban specialist center. J Natl Med Assoc. 2005, 97 (12): 1672-1681.PubMedPubMedCentral Oladapo OT, Daniel OJ, Odusoga OL, Ayoola-Sotubo O: Fertility desires and intentions of HIV-positive patients at a suburban specialist center. J Natl Med Assoc. 2005, 97 (12): 1672-1681.PubMedPubMedCentral
26.
go back to reference Weller S, Davis K: Condom effectiveness in reducing heterosexual HIV transmission. Cochrane Database Syst Rev. 2002, 1: CD003255.PubMed Weller S, Davis K: Condom effectiveness in reducing heterosexual HIV transmission. Cochrane Database Syst Rev. 2002, 1: CD003255.PubMed
27.
go back to reference Pinkerton SD, Abramson PR: Effectiveness of condoms in preventing HIV transmission. Soc Sci Med. 1997, 44 (9): 1303-1312. 10.1016/S0277-9536(96)00258-4.CrossRefPubMed Pinkerton SD, Abramson PR: Effectiveness of condoms in preventing HIV transmission. Soc Sci Med. 1997, 44 (9): 1303-1312. 10.1016/S0277-9536(96)00258-4.CrossRefPubMed
28.
go back to reference Kaida A, Laher F, Strathdee SA, Janssen PA, Money D, Hogg RS, Gray G: Childbearing intentions of HIV-positive women of reproductive age in Soweto, south Africa: the influence of expanding access to HAART in an HIV hyperendemic setting. Am J Public Health. 2011, 101 (2): 350-358. 10.2105/AJPH.2009.177469.CrossRefPubMedPubMedCentral Kaida A, Laher F, Strathdee SA, Janssen PA, Money D, Hogg RS, Gray G: Childbearing intentions of HIV-positive women of reproductive age in Soweto, south Africa: the influence of expanding access to HAART in an HIV hyperendemic setting. Am J Public Health. 2011, 101 (2): 350-358. 10.2105/AJPH.2009.177469.CrossRefPubMedPubMedCentral
29.
go back to reference Gogna ML, Pecheny MM, Ibarlucía I, Manzelli H, López SB: The reproductive needs and rights of people living with HIV in Argentina: health service users’ and providers’ perspectives. Soc Sci Med. 2009, 69 (6): 813-820. 10.1016/j.socscimed.2009.06.002.CrossRefPubMed Gogna ML, Pecheny MM, Ibarlucía I, Manzelli H, López SB: The reproductive needs and rights of people living with HIV in Argentina: health service users’ and providers’ perspectives. Soc Sci Med. 2009, 69 (6): 813-820. 10.1016/j.socscimed.2009.06.002.CrossRefPubMed
30.
go back to reference Andia I, Kaida A, Maier M, Guzman D, Emenyonu N, Pepper L, Bangsberg DR, Hogg RS: Highly active antiretroviral therapy and increased use of contraceptives among HIV-positive women during expanding access to antiretroviral therapy in Mbarara, Uganda. Am J Public Health. 2009, 99 (2): 340-347. 10.2105/AJPH.2007.129528.CrossRefPubMedPubMedCentral Andia I, Kaida A, Maier M, Guzman D, Emenyonu N, Pepper L, Bangsberg DR, Hogg RS: Highly active antiretroviral therapy and increased use of contraceptives among HIV-positive women during expanding access to antiretroviral therapy in Mbarara, Uganda. Am J Public Health. 2009, 99 (2): 340-347. 10.2105/AJPH.2007.129528.CrossRefPubMedPubMedCentral
32.
go back to reference King R, Khana K, Nakayiwa S, Katuntu D, Homsy J, Lindkvist P, Johansson E, 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, Lindkvist P, Johansson E, 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
33.
go back to reference Heard I, Potard V, Costagliola D, Kazatchkine MD: Contraceptive use in HIV-positive women. J Acquir Immune Defic Syndr. 2004, 36 (2): 714-720. 10.1097/00126334-200406010-00008.CrossRefPubMed Heard I, Potard V, Costagliola D, Kazatchkine MD: Contraceptive use in HIV-positive women. J Acquir Immune Defic Syndr. 2004, 36 (2): 714-720. 10.1097/00126334-200406010-00008.CrossRefPubMed
Metadata
Title
Contraceptive use and unmet need for family planning among HIV positive women on antiretroviral therapy in Kumasi, Ghana
Authors
Dennis Odai Laryea
Yaw Ampem Amoako
Kathryn Spangenberg
Ebenezer Frimpong
Judith Kyei-Ansong
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Women's Health / Issue 1/2014
Electronic ISSN: 1472-6874
DOI
https://doi.org/10.1186/1472-6874-14-126

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