The influence of partnership on contraceptive use among HIV-infected women accessing antiretroviral therapy in rural Uganda
Identifieur interne : 001823 ( Pmc/Corpus ); précédent : 001822; suivant : 001824The influence of partnership on contraceptive use among HIV-infected women accessing antiretroviral therapy in rural Uganda
Auteurs : Christina I. Nieves ; Angela Kaida ; George R. Seage ; Jerome Kabakyenga ; Winnie Muyindike ; Yap Boum ; A. Rain Mocello ; Jeffrey N. Martin ; Peter W. Hunt ; Jessica E. Haberer ; David R. Bangsberg ; Lynn T. MatthewsSource :
- 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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Seage</name><affiliation><nlm:aff id="A1">Harvard School of Public Health, Boston, United States</nlm:aff></affiliation></author><author><name sortKey="Kabakyenga, Jerome" sort="Kabakyenga, Jerome" uniqKey="Kabakyenga J" first="Jerome" last="Kabakyenga">Jerome Kabakyenga</name><affiliation><nlm:aff id="A3">Mbarara University of Science and Technology (MUST), Mbarara, Uganda</nlm:aff></affiliation></author><author><name sortKey="Muyindike, Winnie" sort="Muyindike, Winnie" uniqKey="Muyindike W" first="Winnie" last="Muyindike">Winnie Muyindike</name><affiliation><nlm:aff id="A3">Mbarara University of Science and Technology (MUST), Mbarara, Uganda</nlm:aff></affiliation></author><author><name sortKey="Boum, Yap" sort="Boum, Yap" uniqKey="Boum Y" first="Yap" last="Boum">Yap Boum</name><affiliation><nlm:aff id="A3">Mbarara University of Science and Technology (MUST), Mbarara, Uganda</nlm:aff></affiliation><affiliation><nlm:aff id="A4">Epicentre Mbarara, Mbarara, Uganda</nlm:aff></affiliation></author><author><name sortKey="Mocello, A Rain" sort="Mocello, A Rain" uniqKey="Mocello A" first="A. Rain" last="Mocello">A. Rain Mocello</name><affiliation><nlm:aff id="A5">University of California at San Francisco, San Francisco, United States</nlm:aff></affiliation></author><author><name sortKey="Martin, Jeffrey N" sort="Martin, Jeffrey N" uniqKey="Martin J" first="Jeffrey N." last="Martin">Jeffrey N. Martin</name><affiliation><nlm:aff id="A5">University of California at San Francisco, San Francisco, United States</nlm:aff></affiliation></author><author><name sortKey="Hunt, Peter W" sort="Hunt, Peter W" uniqKey="Hunt P" first="Peter W." last="Hunt">Peter W. Hunt</name><affiliation><nlm:aff id="A5">University of California at San Francisco, San Francisco, United States</nlm:aff></affiliation></author><author><name sortKey="Haberer, Jessica E" sort="Haberer, Jessica E" uniqKey="Haberer J" first="Jessica E." last="Haberer">Jessica E. 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Nieves</name><affiliation><nlm:aff id="A1">Harvard School of Public Health, Boston, United States</nlm:aff></affiliation></author><author><name sortKey="Kaida, Angela" sort="Kaida, Angela" uniqKey="Kaida A" first="Angela" last="Kaida">Angela Kaida</name><affiliation><nlm:aff id="A2">Simon Fraser University, Faculty of Health Sciences, Burnaby, Canada</nlm:aff></affiliation></author><author><name sortKey="Seage, George R" sort="Seage, George R" uniqKey="Seage G" first="George R." last="Seage">George R. Seage</name><affiliation><nlm:aff id="A1">Harvard School of Public Health, Boston, United States</nlm:aff></affiliation></author><author><name sortKey="Kabakyenga, Jerome" sort="Kabakyenga, Jerome" uniqKey="Kabakyenga J" first="Jerome" last="Kabakyenga">Jerome Kabakyenga</name><affiliation><nlm:aff id="A3">Mbarara University of Science and Technology (MUST), Mbarara, Uganda</nlm:aff></affiliation></author><author><name sortKey="Muyindike, Winnie" sort="Muyindike, Winnie" uniqKey="Muyindike W" first="Winnie" last="Muyindike">Winnie Muyindike</name><affiliation><nlm:aff id="A3">Mbarara University of Science and Technology (MUST), Mbarara, Uganda</nlm:aff></affiliation></author><author><name sortKey="Boum, Yap" sort="Boum, Yap" uniqKey="Boum Y" first="Yap" last="Boum">Yap Boum</name><affiliation><nlm:aff id="A3">Mbarara University of Science and Technology (MUST), Mbarara, Uganda</nlm:aff></affiliation><affiliation><nlm:aff id="A4">Epicentre Mbarara, Mbarara, Uganda</nlm:aff></affiliation></author><author><name sortKey="Mocello, A Rain" sort="Mocello, A Rain" uniqKey="Mocello A" first="A. Rain" last="Mocello">A. Rain Mocello</name><affiliation><nlm:aff id="A5">University of California at San Francisco, San Francisco, United States</nlm:aff></affiliation></author><author><name sortKey="Martin, Jeffrey N" sort="Martin, Jeffrey N" uniqKey="Martin J" first="Jeffrey N." last="Martin">Jeffrey N. Martin</name><affiliation><nlm:aff id="A5">University of California at San Francisco, San Francisco, United States</nlm:aff></affiliation></author><author><name sortKey="Hunt, Peter W" sort="Hunt, Peter W" uniqKey="Hunt P" first="Peter W." last="Hunt">Peter W. Hunt</name><affiliation><nlm:aff id="A5">University of California at San Francisco, San Francisco, United States</nlm:aff></affiliation></author><author><name sortKey="Haberer, Jessica E" sort="Haberer, Jessica E" uniqKey="Haberer J" first="Jessica E." last="Haberer">Jessica E. Haberer</name><affiliation><nlm:aff id="A6">Massachusetts General Hospital, Center for Global Health & Department of Medicine, Boston, United States</nlm:aff></affiliation></author><author><name sortKey="Bangsberg, David R" sort="Bangsberg, David R" uniqKey="Bangsberg D" first="David R." last="Bangsberg">David R. Bangsberg</name><affiliation><nlm:aff id="A3">Mbarara University of Science and Technology (MUST), Mbarara, Uganda</nlm:aff></affiliation><affiliation><nlm:aff id="A7">Massachusetts General Hospital, Center for Global Health & Division of Infectious Disease, Boston, United States</nlm:aff></affiliation></author><author><name sortKey="Matthews, Lynn T" sort="Matthews, Lynn T" uniqKey="Matthews L" first="Lynn T" last="Matthews">Lynn T. Matthews</name><affiliation><nlm:aff id="A7">Massachusetts General Hospital, Center for Global Health & Division of Infectious Disease, Boston, United States</nlm:aff></affiliation></author></analytic><series><title level="j">Contraception</title><idno type="ISSN">0010-7824</idno><idno type="eISSN">1879-0518</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><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><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">0234361</journal-id><journal-id journal-id-type="pubmed-jr-id">3163</journal-id><journal-id journal-id-type="nlm-ta">Contraception</journal-id><journal-id journal-id-type="iso-abbrev">Contraception</journal-id><journal-title-group><journal-title>Contraception</journal-title></journal-title-group><issn pub-type="ppub">0010-7824</issn><issn pub-type="epub">1879-0518</issn></journal-meta><article-meta><article-id pub-id-type="pmid">25983013</article-id><article-id pub-id-type="pmc">4941236</article-id><article-id pub-id-type="doi">10.1016/j.contraception.2015.04.011</article-id><article-id pub-id-type="manuscript">NIHMS698177</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>The influence of partnership on contraceptive use among HIV-infected women accessing antiretroviral therapy in rural Uganda</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Nieves</surname><given-names>Christina I.</given-names></name><degrees>SM</degrees><xref ref-type="aff" rid="A1">a</xref></contrib><contrib contrib-type="author"><name><surname>Kaida</surname><given-names>Angela</given-names></name><degrees>PhD</degrees><xref ref-type="aff" rid="A2">b</xref></contrib><contrib contrib-type="author"><name><surname>Seage</surname><given-names>George R.</given-names><suffix>III</suffix></name><degrees>ScD MPH</degrees><xref ref-type="aff" rid="A1">a</xref></contrib><contrib contrib-type="author"><name><surname>Kabakyenga</surname><given-names>Jerome</given-names></name><degrees>MBChB MPH</degrees><xref ref-type="aff" rid="A3">c</xref></contrib><contrib contrib-type="author"><name><surname>Muyindike</surname><given-names>Winnie</given-names></name><degrees>MBChB MMed</degrees><xref ref-type="aff" rid="A3">c</xref></contrib><contrib contrib-type="author"><name><surname>Boum</surname><given-names>Yap</given-names></name><degrees>PhD</degrees><xref ref-type="aff" rid="A3">c</xref><xref ref-type="aff" rid="A4">d</xref></contrib><contrib contrib-type="author"><name><surname>Mocello</surname><given-names>A. Rain</given-names></name><degrees>MPH</degrees><xref ref-type="aff" rid="A5">e</xref></contrib><contrib contrib-type="author"><name><surname>Martin</surname><given-names>Jeffrey N.</given-names></name><degrees>MD MPH</degrees><xref ref-type="aff" rid="A5">e</xref></contrib><contrib contrib-type="author"><name><surname>Hunt</surname><given-names>Peter W.</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A5">e</xref></contrib><contrib contrib-type="author"><name><surname>Haberer</surname><given-names>Jessica E.</given-names></name><degrees>MD MS</degrees><xref ref-type="aff" rid="A6">f</xref></contrib><contrib contrib-type="author"><name><surname>Bangsberg</surname><given-names>David R.</given-names></name><degrees>MD MPH</degrees><xref ref-type="aff" rid="A3">c</xref><xref ref-type="aff" rid="A7">g</xref></contrib><contrib contrib-type="author"><name><surname>Matthews</surname><given-names>Lynn T</given-names></name><degrees>MD MPH</degrees><xref ref-type="aff" rid="A7">g</xref></contrib></contrib-group><aff id="A1"><label>a</label>Harvard School of Public Health, Boston, United States</aff><aff id="A2"><label>b</label>Simon Fraser University, Faculty of Health Sciences, Burnaby, Canada</aff><aff id="A3"><label>c</label>Mbarara University of Science and Technology (MUST), Mbarara, Uganda</aff><aff id="A4"><label>d</label>Epicentre Mbarara, Mbarara, Uganda</aff><aff id="A5"><label>e</label>University of California at San Francisco, San Francisco, United States</aff><aff id="A6"><label>f</label>Massachusetts General Hospital, Center for Global Health & Department of Medicine, Boston, United States</aff><aff id="A7"><label>g</label>Massachusetts General Hospital, Center for Global Health & Division of Infectious Disease, Boston, United States</aff><author-notes><corresp id="cor1">Corresponding author: Lynn T Matthews, MGH-Center for Global Health, 100 Cambridge Street, 15<sup>th</sup> Floor, Boston 02114, <email>ltmatthews@partners.org</email></corresp></author-notes><pub-date pub-type="nihms-submitted"><day>2</day><month>7</month><year>2016</year></pub-date><pub-date pub-type="epub"><day>14</day><month>5</month><year>2015</year></pub-date><pub-date pub-type="ppub"><month>8</month><year>2015</year></pub-date><pub-date pub-type="pmc-release"><day>01</day><month>8</month><year>2016</year></pub-date><volume>92</volume><issue>2</issue><fpage>152</fpage><lpage>159</lpage><pmc-comment>elocation-id from pubmed: 10.1016/j.contraception.2015.04.011</pmc-comment>
<abstract><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></abstract><kwd-group><kwd>HIV</kwd><kwd>antiretroviral therapy</kwd><kwd>family planning</kwd><kwd>contraceptive use</kwd><kwd>Uganda</kwd></kwd-group></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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