The influence of partnership on contraceptive use among HIV-infected women accessing antiretroviral therapy in rural Uganda
Identifieur interne : 001324 ( Main/Merge ); précédent : 001323; suivant : 001325The influence of partnership on contraceptive use among HIV-infected women accessing antiretroviral therapy in rural Uganda
Auteurs : Christina I. Nieves [États-Unis] ; Angela Kaida [Canada] ; George R. Seage [États-Unis] ; Jerome Kabakyenga [Ouganda] ; Winnie Muyindike [Ouganda] ; Yap Boum [Ouganda] ; A. Rain Mocello [États-Unis] ; Jeffrey N. Martin [États-Unis] ; Peter W. Hunt [États-Unis] ; Jessica E. Haberer [États-Unis] ; David R. Bangsberg [Ouganda, États-Unis] ; Lynn T. Matthews [États-Unis]Source :
- Contraception [ 0010-7824 ] ; 2015.
Abstract
To determine individual and dyadic factors associated with effective contraceptive use among HIV-infected women accessing antiretroviral therapy (ART) in rural Uganda.
HIV-infected women enrolled in the Uganda AIDS Rural Treatment Outcomes cohort completed questionnaires (detailing socio-behavioral characteristics, sexual and reproductive history, contraceptive use, fertility desires), and phlebotomy (October 2011–March 2013). We describe prevalence of effective contraceptive use (i.e., consistent condom use, and/or oral contraceptives, injectable hormonal contraception, intrauterine device, female sterilization) in the previous six months among sexually active, non-pregnant women (18–40 years). We assessed covariates of contraceptive use using multivariable logistic regression.
362 women (median values: age 30 years, CD4 count 397 cells/mm3, 4.0 years since ART initiation) were included. Among 284 sexually active women, 50% did not desire a(nother) child and 51% had a sero-concordant partner. 45% (n=127) reported effective contraceptive use of whom, 57% (n=72) used condoms, 42% (n=53) injectables, 12% (n=15) oral contraceptives, and 11% (n=14) other effective methods. Dual contraception was reported by 6% (n=8). Only ‘partnership fertility desire’ was independently associated with contraceptive use; women who reported neither partner desired a child had significantly increased odds of contraceptive use (aOR: 2.40, 95% CI: 1.07–5.35) compared with women in partnerships where at least one partner desired a child.
Less than half of sexually active HIV-infected women accessing ART used effective contraception, of which 44% (n=56) relied exclusively on male condoms, highlighting a continued need to expand access to a wider range of longer acting female-controlled contraceptive methods. Association with partnership fertility desire underscores the need to include men in reproductive health programming.
Url:
DOI: 10.1016/j.contraception.2015.04.011
PubMed: 25983013
PubMed Central: 4941236
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<author><name sortKey="Mocello, A Rain" sort="Mocello, A Rain" uniqKey="Mocello A" first="A. Rain" last="Mocello">A. Rain Mocello</name>
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<placeName><settlement type="city">San Francisco</settlement>
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<author><name sortKey="Martin, Jeffrey N" sort="Martin, Jeffrey N" uniqKey="Martin J" first="Jeffrey N." last="Martin">Jeffrey N. Martin</name>
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<author><name sortKey="Hunt, Peter W" sort="Hunt, Peter W" uniqKey="Hunt P" first="Peter W." last="Hunt">Peter W. Hunt</name>
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<placeName><settlement type="city">San Francisco</settlement>
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<author><name sortKey="Haberer, Jessica E" sort="Haberer, Jessica E" uniqKey="Haberer J" first="Jessica E." last="Haberer">Jessica E. Haberer</name>
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<author><name sortKey="Bangsberg, David R" sort="Bangsberg, David R" uniqKey="Bangsberg D" first="David R." last="Bangsberg">David R. Bangsberg</name>
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<country xml:lang="fr">Ouganda</country>
<wicri:regionArea>Mbarara University of Science and Technology (MUST), Mbarara</wicri:regionArea>
<wicri:noRegion>Mbarara</wicri:noRegion>
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<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Massachusetts General Hospital, Center for Global Health & Division of Infectious Disease, Boston</wicri:regionArea>
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<region type="state">Massachusetts</region>
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<author><name sortKey="Matthews, Lynn T" sort="Matthews, Lynn T" uniqKey="Matthews L" first="Lynn T" last="Matthews">Lynn T. Matthews</name>
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<series><title level="j">Contraception</title>
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<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Objective</title>
<p id="P1">To determine individual and dyadic factors associated with effective contraceptive use among HIV-infected women accessing antiretroviral therapy (ART) in rural Uganda.</p>
</sec>
<sec id="S2"><title>Study Design</title>
<p id="P2">HIV-infected women enrolled in the Uganda AIDS Rural Treatment Outcomes cohort completed questionnaires (detailing socio-behavioral characteristics, sexual and reproductive history, contraceptive use, fertility desires), and phlebotomy (October 2011–March 2013). We describe prevalence of effective contraceptive use (i.e., consistent condom use, and/or oral contraceptives, injectable hormonal contraception, intrauterine device, female sterilization) in the previous six months among sexually active, non-pregnant women (18–40 years). We assessed covariates of contraceptive use using multivariable logistic regression.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">362 women (median values: age 30 years, CD4 count 397 cells/mm<sup>3</sup>
, 4.0 years since ART initiation) were included. Among 284 sexually active women, 50% did not desire a(nother) child and 51% had a sero-concordant partner. 45% (n=127) reported effective contraceptive use of whom, 57% (n=72) used condoms, 42% (n=53) injectables, 12% (n=15) oral contraceptives, and 11% (n=14) other effective methods. Dual contraception was reported by 6% (n=8). Only ‘partnership fertility desire’ was independently associated with contraceptive use; women who reported neither partner desired a child had significantly increased odds of contraceptive use (aOR: 2.40, 95% CI: 1.07–5.35) compared with women in partnerships where at least one partner desired a child.</p>
</sec>
<sec id="S4"><title>Conclusions</title>
<p id="P4">Less than half of sexually active HIV-infected women accessing ART used effective contraception, of which 44% (n=56) relied exclusively on male condoms, highlighting a continued need to expand access to a wider range of longer acting female-controlled contraceptive methods. Association with partnership fertility desire underscores the need to include men in reproductive health programming.</p>
</sec>
</div>
</front>
</TEI>
</record>
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