Skip to main content
Top
Published in: BMC Women's Health 1/2018

Open Access 01-12-2018 | Research article

Contraceptive use and method preference among HIV-positive women in Amhara region, Ethiopia

Authors: Kefyalew Addis Alene, Kendalem Asmare Atalell

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

Login to get access

Abstract

Background

Providing preferred methods of contraceptive for HIV-positive women and avoiding unintended pregnancy is one of the primary means of preventing mother to child transmission of HIV. This study assessed the prevalence of contraceptive use and method preference among HIV-positive women in Amhara region, Ethiopia.

Methods

A cross-sectional survey was conducted among HIV-positive women in three referral hospitals of Amhara region. Data were collected by interviewing HIV-positive women using a pre-tested and structured questionnaire. A binary logistic regression model was used to identify factors associated with contraceptive use, and odd ratio with 95% confidence interval (CI) was calculated to measure the strength of association.

Results

A total of 803 women living with HIV (with a response rate of 95.4%) were interviewed. The mean age of the study participants was 32.2 years (SD ± 6.2 years). The prevalence of current contraceptive use was 30.3% (95% CI: 27.0–33.7%). The preferred and most commonly used contraceptive methods were injectable (42.8%) and male condom (32.9%). Younger age group (15–24 years) (AOR = 9.67; 95%CI: 3.45, 27.10), one or more number of living children (AOR = 4.01; 95%CI: 2.07, 7.79), HIV diagnosis > 2–4 years (AOR = 2.37; 95%CI: 1.10, 5.08), and having high CD4 count > 500 cell/ul (AOR = 3.25; 95% CI: 1.42, 7.44) were significantly associated with contraceptive use.

Conclusion

The prevalence of contraceptive use among HIV-positive women in Amhara region referral hospitals is low, which suggests a high risk of unintended pregnancy. Injectable and male condoms are the most preferred type of contraceptive methods. Thus, it is better to integrate these contraceptive methods with ART clinic.
Appendix
Available only for authorised users
Literature
1.
go back to reference Desgrees-Du-Lou A, Msellati P, Viho I, Yao A, Yapi D. Contraceptive use, protected sexual intercourse and incidence of pregnancies among African HIV-infected women. Int J STD AIDS. 2002;13:462–8.CrossRefPubMed Desgrees-Du-Lou A, Msellati P, Viho I, Yao A, Yapi D. Contraceptive use, protected sexual intercourse and incidence of pregnancies among African HIV-infected women. Int J STD AIDS. 2002;13:462–8.CrossRefPubMed
2.
go back to reference Rochat TJ, Richter LM, Doll HA, Buthelezi NP, ATomkins. Depression among pregnant rural south African women undergoing HIV testing. JAMA. 2006;295:1376–8.CrossRefPubMed Rochat TJ, Richter LM, Doll HA, Buthelezi NP, ATomkins. Depression among pregnant rural south African women undergoing HIV testing. JAMA. 2006;295:1376–8.CrossRefPubMed
3.
go back to reference Deneke K, Rubin J, Franklin N, Guyon A. Prevention of mother to child transmission (PMTCT) baseline survey Ethiopia. AED-LINKAGES. 2004; Deneke K, Rubin J, Franklin N, Guyon A. Prevention of mother to child transmission (PMTCT) baseline survey Ethiopia. AED-LINKAGES. 2004;
4.
go back to reference WHO. Health benefits of family planning. Geneva: WHO; 1995. WHO. Health benefits of family planning. Geneva: WHO; 1995.
5.
go back to reference Reynolds HW, Janowitz B, Homan R, Johnson L. The value of contraception to prevent perinatal HIV transmission. Sex Transm Dis. 2006;33:350–6.CrossRefPubMed Reynolds HW, Janowitz B, Homan R, Johnson L. The value of contraception to prevent perinatal HIV transmission. Sex Transm Dis. 2006;33:350–6.CrossRefPubMed
6.
go back to reference Horton R. The continuing invisibility of women and children. Lancet. 375:1941–3. Horton R. The continuing invisibility of women and children. Lancet. 375:1941–3.
7.
go back to reference WHO. Prevention of HIV in infants and young children: review of evidence and WHO's activities. Geneva: WHO; 2002. WHO. Prevention of HIV in infants and young children: review of evidence and WHO's activities. Geneva: WHO; 2002.
8.
go back to reference Petruney T, Robinson E, Reynolds H, Wilcher R, Cates W. Contraception is the best kept secret for prevention of mother-to-child HIV transmission. Bull World Health Organ. 2008;86(6). Petruney T, Robinson E, Reynolds H, Wilcher R, Cates W. Contraception is the best kept secret for prevention of mother-to-child HIV transmission. Bull World Health Organ. 2008;86(6).
9.
go back to reference Andia I, Kaida A, Maier M, Emenyonu DGN. 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;99:340–7.CrossRefPubMedPubMedCentral Andia I, Kaida A, Maier M, Emenyonu DGN. 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;99:340–7.CrossRefPubMedPubMedCentral
10.
go back to reference Kaida A, Andia I, Maier M, Strathdee SA, Bangsberg DR. The potential impact of antiretroviral therapy on fertility in sub-Saharan Africa. Curr HIV/AIDS Rep. 2006;3:187–94.CrossRefPubMed Kaida A, Andia I, Maier M, Strathdee SA, Bangsberg DR. The potential impact of antiretroviral therapy on fertility in sub-Saharan Africa. Curr HIV/AIDS Rep. 2006;3:187–94.CrossRefPubMed
11.
go back to reference FMOH: Accelerated plan for scaling up prevention of mother to child transmission (PMTCT) Services in Ethiopia. 2011. FMOH: Accelerated plan for scaling up prevention of mother to child transmission (PMTCT) Services in Ethiopia. 2011.
12.
go back to reference Joseph P, Desai VBR, Mohan NS, Fredrick JS, Ramachandran R, Raman B, Wares F, Ramachandran R, Thomas A. Outcome of standardized treatment for patients with MDR-TB from Tamil Nadu, India. Indian J Med Res. 2011;133(5):529.PubMedPubMedCentral Joseph P, Desai VBR, Mohan NS, Fredrick JS, Ramachandran R, Raman B, Wares F, Ramachandran R, Thomas A. Outcome of standardized treatment for patients with MDR-TB from Tamil Nadu, India. Indian J Med Res. 2011;133(5):529.PubMedPubMedCentral
13.
go back to reference FDRE: Country progress report on HIV/AIDS response. 2012. FDRE: Country progress report on HIV/AIDS response. 2012.
14.
go back to reference UNICEF: Global plan towards eliminating new infections among children by 2015 and keeping their mothers alive. Geneva, Switzerland 2011. UNICEF: Global plan towards eliminating new infections among children by 2015 and keeping their mothers alive. Geneva, Switzerland 2011.
15.
go back to reference Federal HIV/AIDS Prevention & Control Office. Multi-sectoral HIV/AIDS response monitoring and evaluation report 2011. Federal HIV/AIDS Prevention & Control Office. Multi-sectoral HIV/AIDS response monitoring and evaluation report 2011.
16.
go back to reference USAID: Ethiopia: HIV/AIDS health profile. 2012. USAID: Ethiopia: HIV/AIDS health profile. 2012.
17.
go back to reference CSA. Population projection of Ethiopia for all regions at wereda level from 2014–2017. Addis Ababa: Central Statistical Agency of Ethiopia; 2013. CSA. Population projection of Ethiopia for all regions at wereda level from 2014–2017. Addis Ababa: Central Statistical Agency of Ethiopia; 2013.
18.
go back to reference Tamene W, Fantahun M. Fertility desire and family-planning demand among HIV-positive women and men undergoing antiretroviral treatment in Addis Ababa, Ethiopia. African J AIDS Res. 2007;6(3):223–7.CrossRef Tamene W, Fantahun M. Fertility desire and family-planning demand among HIV-positive women and men undergoing antiretroviral treatment in Addis Ababa, Ethiopia. African J AIDS Res. 2007;6(3):223–7.CrossRef
19.
go back to reference CSA I. Ethiopia Demographic and Health Survey 2016. Addis Ababa, Ethiopia, and Rockville, Maryland, USA: Central Statistical Agency (CSA) [Ethiopia] and ICF; 2016. CSA I. Ethiopia Demographic and Health Survey 2016. Addis Ababa, Ethiopia, and Rockville, Maryland, USA: Central Statistical Agency (CSA) [Ethiopia] and ICF; 2016.
21.
go back to reference Allen RH, Cwiak CA, Kaunitz AM. Contraception in women over 40 years of age. Can Med Assoc J. 2013;185(7):565–73.CrossRef Allen RH, Cwiak CA, Kaunitz AM. Contraception in women over 40 years of age. Can Med Assoc J. 2013;185(7):565–73.CrossRef
22.
go back to reference Karraker A, DeLamater J, Schwartz CR. Sexual frequency decline from midlife to later life. J Gerontol B Psychol Sci Soc Sci. 2011;66((4):502–12.CrossRef Karraker A, DeLamater J, Schwartz CR. Sexual frequency decline from midlife to later life. J Gerontol B Psychol Sci Soc Sci. 2011;66((4):502–12.CrossRef
23.
go back to reference Kaida A, Laher F, Strathdee SA, Money D, Janssen PA, Hogg RS, Gray G. Contraceptive use and method preference among women in Soweto, South Africa: the influence of expanding access to HIV care and treatment services. PLoS One. 2010;5(11):e13868.CrossRefPubMedPubMedCentral Kaida A, Laher F, Strathdee SA, Money D, Janssen PA, Hogg RS, Gray G. Contraceptive use and method preference among women in Soweto, South Africa: the influence of expanding access to HIV care and treatment services. PLoS One. 2010;5(11):e13868.CrossRefPubMedPubMedCentral
24.
go back to reference Alene KA. Consistent condom use among sexually active HIV positive women in Amhara region, Ethiopia. Open Access J Contracept. 2014;5:85–90.CrossRef Alene KA. Consistent condom use among sexually active HIV positive women in Amhara region, Ethiopia. Open Access J Contracept. 2014;5:85–90.CrossRef
25.
go back to reference UN: World Contraceptive Use. New York: Department of Economic and Social Affairs, Population Division; 2007. UN: World Contraceptive Use. New York: Department of Economic and Social Affairs, Population Division; 2007.
26.
go back to reference Nattabi B, Li J, Thompson SC, Orach CG, Earnest J. Family planning among people living with HIV in post-conflict northern Uganda: a mixed methods study. BioMed Central Conflict and Health. 2011;5(18) Nattabi B, Li J, Thompson SC, Orach CG, Earnest J. Family planning among people living with HIV in post-conflict northern Uganda: a mixed methods study. BioMed Central Conflict and Health. 2011;5(18)
27.
go back to reference Harvey SM, Bird ST, Galavotti C, Duncan EA, Greenberg D. Relationship power, sexual decision making and condom use among women at risk for HIV/STDs. Women Health. 2002;36(4):69–84.CrossRefPubMed Harvey SM, Bird ST, Galavotti C, Duncan EA, Greenberg D. Relationship power, sexual decision making and condom use among women at risk for HIV/STDs. Women Health. 2002;36(4):69–84.CrossRefPubMed
28.
go back to reference Teitelman AM, Ratcliffe SJ, Dichter ME, Sullivan CM. Recent and past intimate partner abuse and HIV risk among young women. J Obstet Gynecol Neonatal Nurs. 2008;37(2):219–27.CrossRefPubMedPubMedCentral Teitelman AM, Ratcliffe SJ, Dichter ME, Sullivan CM. Recent and past intimate partner abuse and HIV risk among young women. J Obstet Gynecol Neonatal Nurs. 2008;37(2):219–27.CrossRefPubMedPubMedCentral
29.
go back to reference Kaida A, Laher F, Strathdee SA, Money D, Janssen PA, Hogg RS, Gray G. Contraceptive use and method preference amongWomen in Soweto, South Africa: the influence of expanding access to HIV care and treatment services. PLoS One. 2010;5(11):e13868.CrossRefPubMedPubMedCentral Kaida A, Laher F, Strathdee SA, Money D, Janssen PA, Hogg RS, Gray G. Contraceptive use and method preference amongWomen in Soweto, South Africa: the influence of expanding access to HIV care and treatment services. PLoS One. 2010;5(11):e13868.CrossRefPubMedPubMedCentral
30.
go back to reference Gelaw YA, Biks GA, Alene KA. Effect of residence on mothers’ health care seeking behavior for common childhood illness in Northwest Ethiopia: a community based comparative cross–sectional study. BMC research notes. 2014;7(1):705.CrossRefPubMedPubMedCentral Gelaw YA, Biks GA, Alene KA. Effect of residence on mothers’ health care seeking behavior for common childhood illness in Northwest Ethiopia: a community based comparative cross–sectional study. BMC research notes. 2014;7(1):705.CrossRefPubMedPubMedCentral
31.
32.
go back to reference Spangler SA, Onono M, Bukusi EA, Cohen CR, Turan JM. HIV-positive status disclosure and use of essential PMTCT and maternal health services in rural Kenya. J Acquir Immune Defic Syndr. 2014;67(Suppl 4):S235.CrossRefPubMedPubMedCentral Spangler SA, Onono M, Bukusi EA, Cohen CR, Turan JM. HIV-positive status disclosure and use of essential PMTCT and maternal health services in rural Kenya. J Acquir Immune Defic Syndr. 2014;67(Suppl 4):S235.CrossRefPubMedPubMedCentral
33.
go back to reference Augustine JM, Nelson T, Edin K. Why do poor men have children? Fertility intentions among low-income unmarried US fathers. Ann Am Acad Pol Soc Sci. 2009;624(1):99–117.CrossRef Augustine JM, Nelson T, Edin K. Why do poor men have children? Fertility intentions among low-income unmarried US fathers. Ann Am Acad Pol Soc Sci. 2009;624(1):99–117.CrossRef
34.
go back to reference Gallant MP, Spitze G, Grove JG. Chronic illness self-care and the family lives of older adults: a synthetic review across four ethnic groups. J Cross Cult Gerontol. 2010;25(1):21–43.CrossRefPubMedPubMedCentral Gallant MP, Spitze G, Grove JG. Chronic illness self-care and the family lives of older adults: a synthetic review across four ethnic groups. J Cross Cult Gerontol. 2010;25(1):21–43.CrossRefPubMedPubMedCentral
35.
go back to reference Gelaw YA, Senbete GH, Adane AA, Alene KA. Determinants of late presentation to HIV/AIDS care in southern Tigray zone, northern Ethiopia: an institution based case–control study. AIDS Res Ther. 2015;12(1):40.CrossRefPubMedPubMedCentral Gelaw YA, Senbete GH, Adane AA, Alene KA. Determinants of late presentation to HIV/AIDS care in southern Tigray zone, northern Ethiopia: an institution based case–control study. AIDS Res Ther. 2015;12(1):40.CrossRefPubMedPubMedCentral
36.
go back to reference Schackman BR, Dastur Z, Ni Q, Callahan MA, Berger J, Rubin DS. Sexually active HIV-positive patients frequently report never using condoms in audio computer-assisted self-interviews conducted at routine clinical visits. AIDS Patient Care STDs. 2008;22(2):123–9.CrossRefPubMed Schackman BR, Dastur Z, Ni Q, Callahan MA, Berger J, Rubin DS. Sexually active HIV-positive patients frequently report never using condoms in audio computer-assisted self-interviews conducted at routine clinical visits. AIDS Patient Care STDs. 2008;22(2):123–9.CrossRefPubMed
37.
go back to reference Birhane T, Assefa Tessema G, Addis Alene K, Dadi AF. Knowledge of pregnant women on mother-to-child transmission of HIV in Meket District, Northeast Ethiopia. J Pregnancy. 2015;2015:101–7.CrossRef Birhane T, Assefa Tessema G, Addis Alene K, Dadi AF. Knowledge of pregnant women on mother-to-child transmission of HIV in Meket District, Northeast Ethiopia. J Pregnancy. 2015;2015:101–7.CrossRef
Metadata
Title
Contraceptive use and method preference among HIV-positive women in Amhara region, Ethiopia
Authors
Kefyalew Addis Alene
Kendalem Asmare Atalell
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/s12905-018-0608-y

Other articles of this Issue 1/2018

BMC Women's Health 1/2018 Go to the issue