Factors influencing the utilization of family planning services among HIV infected women in a Kenyan health facility
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20171935Keywords:
Family Planning, Human immunodeficiency virus, WomenAbstract
Background: Women’s knowledge and access to reproductive health services improves their ability to safely achieve their required fertility and reduces maternal and infant morbidity and mortality. We aimed to determine the utilization of family planning (FP) among HIV Infected women visiting the HIV clinic.
Methods: A cross-sectional mixed quantitative and qualitative study among HIV positive females in Nairobi, Kenya was conducted. Consenting women completed a questionnaire that assessed the utilization of FP services. Descriptive and inferential analysis was carried out on quantitative data to determine significant associations with FP utilization. Qualitative data were analyzed after coding for significant clauses and transcribing to determine themes arising.
Results: We enrolled a total of 387 patients, mean age (IQ range) 40 years (36-44). The contraceptive prevalence was 53% with an unmet need of family planning of 38.5%. Patients were more likely to use family planning if they were married, if condoms were offered at the clinic, if they discussed contraception with the clinic staff and their partners. They were less likely to use FP if they had expressed fertility desire. Widows were less likely to use any form of FP than married couples despite having sexual partners. The main themes on the barriers of utilization of family planning services included lack of knowledge, pill burden, and adverse reactions to hormonal FP.
Conclusions: The unmet need of family planning is high, and heightened measures need to be taken to improve the utilization of the service. Particular groups such as sexually active widows and single women should be targeted for these interventions.
References
UNAIDS World AIDS Day Report, Global estimates UNAIDS; 2011.
Kenya Demographic Health Survey; 2008-2009.
Kaloustian KW, Kimaiyo S, and Lameck D. Viability and effectiveness of large-scale HIV treatment initiatives in sub-Saharan Africa: experience from western Kenya. 2006;20(1)41-8.
Delaney KM, Moorman AC, Palella FJ. Declining Morbidity and Mortality among Patients with Advanced Human Immunodeficiency Virus Infection. 1998;338:853-60.
World Health Organization Reproductive Health Website, Prevention of mother-to-child transmission of HIV (PMTCT) and family planning (FP); 2012.
Lush L, Cleland J, Walt G, Mayhew S. Integrating reproductive health: myth and ideology. Bulletin-World Health Organization. 1999;77:771-7.
Wilcher, Rose, and Willard Cates. "Reproductive choices for women with HIV." Bulletin of the World Health Organization 87.11 (2009): 833-839.
WHO/UN FPA/UNA IDS/IPPF. Sexual and Reproductive Health and HIV/AIDS. A Framework for Priority Linkages; 2005.
World Health Organization Reproductive Health website, "New national-level core indicator for monitoring and evaluating family planning aspect of PMTCT programmes; 2012.
Singh S. Adding it all up: The costs and benefits of investing in family planning and maternal and newborn health; 2009.
Best K. Best K. Family planning and the prevention of mother-to-child transmission of HIV: a review of the literature; 2004.
The Centers for Disease Control and prevention website, Unintended Pregnancy Prevention; 2012.
World Health Organization. Interagency Task Team on Prevention of HIV infection in pregnant women. Towards Universal Access for Women, Infants and Young Children and Eliminating HIV and Aids Among Children; 2007.
K 4 Health Website on prevention of mother to child transmission, Preventing Unintended Pregnancies Among HIV-Positive Women; 2012.
Amy E Pollack, Family Planning and HIV: a close look at Kenya; 2012.
The Guttmacher Institute, Unsafe Abortion in Kenya. Available from: http://www.guttmacher.org/pubs/FB_Abortion-in-Kenya.pdf, no. Accessed on 1st April 2012, 2008.
Harper CC, and Shields WC, Speidel JJ, The Potential of Long-acting Reversible Contraception to Decrease Unintended Pregnancy, Available from: http://www.arhp.org/publications-and resources/contraception-journal/september,no.
Carolyn B, Rutenberg N. Addressing the family planning needs of HIV-positive PMTCT clients: Baseline findings from an operations research study; 2005.
Reynolds HW, Steiner MJ, Cates W. Contraception’s proved potential to fight HIV. 2005;81(2):184-5.
The World Health Organization website, WHO upholds guidance on hormonal contraceptive use and HIV; 2012.
Mwapasa V, "Maternal syphilis infection is associated with increased risk of mother-to-child transmission of HIV in Malawi. 2006;20:1869-77.
United Nations, Department of Economic and Social Affairs, Population Division, World Contraceptive Use. 2010; 2011.
Mutiso SM, Kinuthia J, Qureshi Z. Contraceptive use among HIV infected women attending Comprehensive Care Centre. 2008;85(4):171-7.
Marahatta R, Tuladhar H. Awareness and practice of family planning methods in women attending gyne OPD at Nepal Medical College Teaching Hospital. 2008;10(3):184-91.
Sandelowski M. Sample size in qualitative research Research in Nursing and Health; 1995.
Polisi A. Modern contraceptive utilization among female ART attendees in health facilities of Gimbie town. Reproductive Health; 2014.
Division of Public and Reproductive Health, National Family Planning Guidelines for Service Providers; 2010.
Mutiso SM, Kinuthia J, Qureshi Z. Contraceptive use among HIV infected women attending Comprehensive Care Centre. 2008;85(4):171-7.
SG Brubaker, EA Bukusi, J Odoyo, J Achando, A Okumu and CR Cohen, Pregnancy and HIV transmission among HIV-discordant couples in a clinical trial in Kisumu, Kenya. 2010;1.
Muyindike W, Fatch R, Steinfield R, Lynn T. Matthews. Contraceptive Use and Associated Factors among Women Enrolling into HIV Care in Southwestern Uganda. 2012;340782:9.
Chibwesha CJ, Li MS, Matoba CK, Mbewe RK, Chi BH, Stringer JS, et al. Modern contraceptive and dual method use among HIV-infected women in Lusaka, Zambia. Infectious diseases in obstetrics and gynecology; 2011.
Nakaie N, Tuon S, Nozaki I, Yamaguchi F, Sasaki Y, Kakimoto K. Family planning practice and predictors of risk of inconsistent condom use among HIV-positive women on anti-retroviral therapy in Cambodia. BMC public health. 2014;14(1):170.
Asiimwe D, Kibombo R, Matsiko J, Hardee K. Study of the Integration of Family Planning and VCT/PMTCT/ART Programs in Uganda. Institute of Social Research and the POLICY Project; 2005.
Steinfeld RL, Newmann SJ, Onono M, Cohen CR, Bukusi EA, Grossman D. Overcoming Barriers to Family Planning through Integration: Perspectives of HIV-Positive Men in Nyanza Province, Kenya; 2013.
Enqueselassie F, Haile A. "Influence of women’s autonomy on couple’s contraception use in Jimma town, Ethiopia. 2006;20(3):1-7.
Muyindike W, Fatch R, Steinfield R, Matthews LT, Musinguzi N, Emenyonu NI, et al. Contraceptive Use and Associated Factors among Women Enrolling into HIV Care in Southwestern Uganda. 2012:1-9.
Akelo V, Girde S, Borkowf CB, Angira F, Achola K, Lando R, et al. Attitudes toward family planning among HIV-positive pregnant women enrolled in a prevention of mother-to-child transmission study in Kisumu, Kenya. PloS one. 2013;8(8):66593.
Hoffman IF, Martinson FE, Powers KA, Chilongozi DA, Msiska ED, Kachipapa EI, et al. The year-long effect of HIV-positive test results on pregnancy intentions, contraceptive use, and pregnancy incidence among Malawian women. JAIDS Journal of Acquired Immune Deficiency Syndromes. 2008;47(4):477-83.
