Contraceptive use among HIV-infected women and men receiving antiretroviral therapy in Lusaka, Zambia: a cross-sectional survey
Identifieur interne : 000762 ( Pmc/Curation ); précédent : 000761; suivant : 000763Contraceptive use among HIV-infected women and men receiving antiretroviral therapy in Lusaka, Zambia: a cross-sectional survey
Auteurs : Nancy L. Hancock [États-Unis, Zambie] ; Carla J. Chibwesha [États-Unis] ; Samuel Bosomprah [Zambie] ; Jonathan Newman [Zambie] ; Mwangelwa Mubiana-Mbewe [Zambie] ; Elizabeth Siyama Sitali [Zambie] ; Carolyn Bolton-Moore [États-Unis, Zambie] ; Clara Mbwili-Muleya [Zambie] ; Benjamin H. Chi [États-Unis, Zambie]Source :
- BMC Public Health [ 1471-2458 ] ; 2016.
Abstract
Family planning (FP) is an essential health service and an important part of comprehensive HIV care. However, there is limited information about the contraceptive needs of people living with HIV in sub-Saharan Africa, which in turn has hampered efforts to expand and integrate FP services into existing HIV programs.
We performed a cross-sectional survey to determine FP prevalence and predictors among HIV-positive women and men attending 18 public antiretroviral therapy (ART) clinics in Lusaka, Zambia. Trained peer counselors administered the 10-question survey to those seeking care for five days at each of the target sites.
From February to April 2014, we surveyed 7,046 HIV-infected patients receiving routine HIV services. Use of modern contraception was reported by 69 % of female ART patients and 79 % of male ART patients. However, highly effective contraceptive use and dual method use were low among women (38 and 25 %, respectively) and men (19 and 14 %, respectively). HIV disclosure status (adjusted odds ratio (AOR) = 4.91, 95 % confidence interval (CI) = 3.32–7.24 for women, AOR = 3.58, 95 % CI = 2.39–5.38 for men) and sexual activity in the last 6 months (AOR = 5.80, 95 % CI = 4.51–7.47 for women, AOR = 6.24, 95 % CI = 3.51–11.08 for men) were associated with modern contraceptive use in multivariable regression. Most respondents said they would access FP services if made available within ART clinic.
While FP-ART integration may be a promising strategy for increasing FP service uptake, such services must focus on assessing sexual activity and advocating for dual method use to increase effective contraceptive use and prevent unintended pregnancies.
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DOI: 10.1186/s12889-016-3070-5
PubMed: 27175483
PubMed Central: 4865985
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Hancock</name><affiliation wicri:level="2"><nlm:aff id="Aff1">Department of Obstetrics and Gynecology, UNC Global Women’s Health, University of North Carolina School of Medicine, 3009 Old Clinic Building, Campus, Box 7577, Chapel Hill, NC 27599-7577 USA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Caroline du Nord</region></placeName><wicri:cityArea>Department of Obstetrics and Gynecology, UNC Global Women’s Health, University of North Carolina School of Medicine, 3009 Old Clinic Building, Campus, Box 7577, Chapel Hill</wicri:cityArea></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff2">Centre for Infectious Disease Research in Zambia, PO Box 34681, 5032 Great North Road, Lusaka, Zambia</nlm:aff><country xml:lang="fr">Zambie</country><wicri:regionArea>Centre for Infectious Disease Research in Zambia, PO Box 34681, 5032 Great North Road, Lusaka</wicri:regionArea></affiliation></author><author><name sortKey="Chibwesha, Carla J" sort="Chibwesha, Carla J" uniqKey="Chibwesha C" first="Carla J." last="Chibwesha">Carla J. 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Chi</name><affiliation wicri:level="2"><nlm:aff id="Aff1">Department of Obstetrics and Gynecology, UNC Global Women’s Health, University of North Carolina School of Medicine, 3009 Old Clinic Building, Campus, Box 7577, Chapel Hill, NC 27599-7577 USA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Caroline du Nord</region></placeName><wicri:cityArea>Department of Obstetrics and Gynecology, UNC Global Women’s Health, University of North Carolina School of Medicine, 3009 Old Clinic Building, Campus, Box 7577, Chapel Hill</wicri:cityArea></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff2">Centre for Infectious Disease Research in Zambia, PO Box 34681, 5032 Great North Road, Lusaka, Zambia</nlm:aff><country xml:lang="fr">Zambie</country><wicri:regionArea>Centre for Infectious Disease Research in Zambia, PO Box 34681, 5032 Great North Road, Lusaka</wicri:regionArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">27175483</idno><idno type="pmc">4865985</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4865985</idno><idno type="RBID">PMC:4865985</idno><idno type="doi">10.1186/s12889-016-3070-5</idno><date when="2016">2016</date><idno type="wicri:Area/Pmc/Corpus">000763</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000763</idno><idno type="wicri:Area/Pmc/Curation">000762</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000762</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Contraceptive use among HIV-infected women and men receiving antiretroviral therapy in Lusaka, Zambia: a cross-sectional survey</title><author><name sortKey="Hancock, Nancy L" sort="Hancock, Nancy L" uniqKey="Hancock N" first="Nancy L." last="Hancock">Nancy L. Hancock</name><affiliation wicri:level="2"><nlm:aff id="Aff1">Department of Obstetrics and Gynecology, UNC Global Women’s Health, University of North Carolina School of Medicine, 3009 Old Clinic Building, Campus, Box 7577, Chapel Hill, NC 27599-7577 USA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Caroline du Nord</region></placeName><wicri:cityArea>Department of Obstetrics and Gynecology, UNC Global Women’s Health, University of North Carolina School of Medicine, 3009 Old Clinic Building, Campus, Box 7577, Chapel Hill</wicri:cityArea></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff2">Centre for Infectious Disease Research in Zambia, PO Box 34681, 5032 Great North Road, Lusaka, Zambia</nlm:aff><country xml:lang="fr">Zambie</country><wicri:regionArea>Centre for Infectious Disease Research in Zambia, PO Box 34681, 5032 Great North Road, Lusaka</wicri:regionArea></affiliation></author><author><name sortKey="Chibwesha, Carla J" sort="Chibwesha, Carla J" uniqKey="Chibwesha C" first="Carla J." last="Chibwesha">Carla J. Chibwesha</name><affiliation wicri:level="2"><nlm:aff id="Aff1">Department of Obstetrics and Gynecology, UNC Global Women’s Health, University of North Carolina School of Medicine, 3009 Old Clinic Building, Campus, Box 7577, Chapel Hill, NC 27599-7577 USA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Caroline du Nord</region></placeName><wicri:cityArea>Department of Obstetrics and Gynecology, UNC Global Women’s Health, University of North Carolina School of Medicine, 3009 Old Clinic Building, Campus, Box 7577, Chapel Hill</wicri:cityArea></affiliation></author><author><name sortKey="Bosomprah, Samuel" sort="Bosomprah, Samuel" uniqKey="Bosomprah S" first="Samuel" last="Bosomprah">Samuel Bosomprah</name><affiliation wicri:level="1"><nlm:aff id="Aff2">Centre for Infectious Disease Research in Zambia, PO Box 34681, 5032 Great North Road, Lusaka, Zambia</nlm:aff><country xml:lang="fr">Zambie</country><wicri:regionArea>Centre for Infectious Disease Research in Zambia, PO Box 34681, 5032 Great North Road, Lusaka</wicri:regionArea></affiliation></author><author><name sortKey="Newman, Jonathan" sort="Newman, Jonathan" uniqKey="Newman J" first="Jonathan" last="Newman">Jonathan Newman</name><affiliation wicri:level="1"><nlm:aff id="Aff2">Centre for Infectious Disease Research in Zambia, PO Box 34681, 5032 Great North Road, Lusaka, Zambia</nlm:aff><country xml:lang="fr">Zambie</country><wicri:regionArea>Centre for Infectious Disease Research in Zambia, PO Box 34681, 5032 Great North Road, Lusaka</wicri:regionArea></affiliation></author><author><name sortKey="Mubiana Mbewe, Mwangelwa" sort="Mubiana Mbewe, Mwangelwa" uniqKey="Mubiana Mbewe M" first="Mwangelwa" last="Mubiana-Mbewe">Mwangelwa Mubiana-Mbewe</name><affiliation wicri:level="1"><nlm:aff id="Aff2">Centre for Infectious Disease Research in Zambia, PO Box 34681, 5032 Great North Road, Lusaka, Zambia</nlm:aff><country xml:lang="fr">Zambie</country><wicri:regionArea>Centre for Infectious Disease Research in Zambia, PO Box 34681, 5032 Great North Road, Lusaka</wicri:regionArea></affiliation></author><author><name sortKey="Sitali, Elizabeth Siyama" sort="Sitali, Elizabeth Siyama" uniqKey="Sitali E" first="Elizabeth Siyama" last="Sitali">Elizabeth Siyama Sitali</name><affiliation wicri:level="1"><nlm:aff id="Aff2">Centre for Infectious Disease Research in Zambia, PO Box 34681, 5032 Great North Road, Lusaka, Zambia</nlm:aff><country xml:lang="fr">Zambie</country><wicri:regionArea>Centre for Infectious Disease Research in Zambia, PO Box 34681, 5032 Great North Road, Lusaka</wicri:regionArea></affiliation></author><author><name sortKey="Bolton Moore, Carolyn" sort="Bolton Moore, Carolyn" uniqKey="Bolton Moore C" first="Carolyn" last="Bolton-Moore">Carolyn Bolton-Moore</name><affiliation wicri:level="2"><nlm:aff id="Aff1">Department of Obstetrics and Gynecology, UNC Global Women’s Health, University of North Carolina School of Medicine, 3009 Old Clinic Building, Campus, Box 7577, Chapel Hill, NC 27599-7577 USA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Caroline du Nord</region></placeName><wicri:cityArea>Department of Obstetrics and Gynecology, UNC Global Women’s Health, University of North Carolina School of Medicine, 3009 Old Clinic Building, Campus, Box 7577, Chapel Hill</wicri:cityArea></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff2">Centre for Infectious Disease Research in Zambia, PO Box 34681, 5032 Great North Road, Lusaka, Zambia</nlm:aff><country xml:lang="fr">Zambie</country><wicri:regionArea>Centre for Infectious Disease Research in Zambia, PO Box 34681, 5032 Great North Road, Lusaka</wicri:regionArea></affiliation></author><author><name sortKey="Mbwili Muleya, Clara" sort="Mbwili Muleya, Clara" uniqKey="Mbwili Muleya C" first="Clara" last="Mbwili-Muleya">Clara Mbwili-Muleya</name><affiliation wicri:level="1"><nlm:aff id="Aff3">Lusaka District Community Health Office, Ministry of Community Development, Mother and Child Health, PO Box 50827, Lusaka, Zambia</nlm:aff><country xml:lang="fr">Zambie</country><wicri:regionArea>Lusaka District Community Health Office, Ministry of Community Development, Mother and Child Health, PO Box 50827, Lusaka</wicri:regionArea></affiliation></author><author><name sortKey="Chi, Benjamin H" sort="Chi, Benjamin H" uniqKey="Chi B" first="Benjamin H." last="Chi">Benjamin H. Chi</name><affiliation wicri:level="2"><nlm:aff id="Aff1">Department of Obstetrics and Gynecology, UNC Global Women’s Health, University of North Carolina School of Medicine, 3009 Old Clinic Building, Campus, Box 7577, Chapel Hill, NC 27599-7577 USA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Caroline du Nord</region></placeName><wicri:cityArea>Department of Obstetrics and Gynecology, UNC Global Women’s Health, University of North Carolina School of Medicine, 3009 Old Clinic Building, Campus, Box 7577, Chapel Hill</wicri:cityArea></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff2">Centre for Infectious Disease Research in Zambia, PO Box 34681, 5032 Great North Road, Lusaka, Zambia</nlm:aff><country xml:lang="fr">Zambie</country><wicri:regionArea>Centre for Infectious Disease Research in Zambia, PO Box 34681, 5032 Great North Road, Lusaka</wicri:regionArea></affiliation></author></analytic><series><title level="j">BMC Public Health</title><idno type="eISSN">1471-2458</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Family planning (FP) is an essential health service and an important part of comprehensive HIV care. However, there is limited information about the contraceptive needs of people living with HIV in sub-Saharan Africa, which in turn has hampered efforts to expand and integrate FP services into existing HIV programs.</p></sec><sec><title>Methods</title><p>We performed a cross-sectional survey to determine FP prevalence and predictors among HIV-positive women and men attending 18 public antiretroviral therapy (ART) clinics in Lusaka, Zambia. Trained peer counselors administered the 10-question survey to those seeking care for five days at each of the target sites.</p></sec><sec><title>Results</title><p>From February to April 2014, we surveyed 7,046 HIV-infected patients receiving routine HIV services. Use of modern contraception was reported by 69 % of female ART patients and 79 % of male ART patients. However, highly effective contraceptive use and dual method use were low among women (38 and 25 %, respectively) and men (19 and 14 %, respectively). HIV disclosure status (adjusted odds ratio (AOR) = 4.91, 95 % confidence interval (CI) = 3.32–7.24 for women, AOR = 3.58, 95 % CI = 2.39–5.38 for men) and sexual activity in the last 6 months (AOR = 5.80, 95 % CI = 4.51–7.47 for women, AOR = 6.24, 95 % CI = 3.51–11.08 for men) were associated with modern contraceptive use in multivariable regression. Most respondents said they would access FP services if made available within ART clinic.</p></sec><sec><title>Conclusions</title><p>While FP-ART integration may be a promising strategy for increasing FP service uptake, such services must focus on assessing sexual activity and advocating for dual method use to increase effective contraceptive use and prevent unintended pregnancies.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Darroch, Je" uniqKey="Darroch J">JE Darroch</name></author><author><name sortKey="Sedgh, G" uniqKey="Sedgh G">G Sedgh</name></author><author><name sortKey="Ball, H" uniqKey="Ball H">H Ball</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Singh, S" uniqKey="Singh S">S Singh</name></author><author><name sortKey="Sedgh, G" uniqKey="Sedgh G">G Sedgh</name></author><author><name sortKey="Hussain, R" uniqKey="Hussain R">R 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<front><journal-meta><journal-id journal-id-type="nlm-ta">BMC Public Health</journal-id><journal-id journal-id-type="iso-abbrev">BMC Public Health</journal-id><journal-title-group><journal-title>BMC Public Health</journal-title></journal-title-group><issn pub-type="epub">1471-2458</issn><publisher><publisher-name>BioMed Central</publisher-name><publisher-loc>London</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">27175483</article-id><article-id pub-id-type="pmc">4865985</article-id><article-id pub-id-type="publisher-id">3070</article-id><article-id pub-id-type="doi">10.1186/s12889-016-3070-5</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group></article-categories><title-group><article-title>Contraceptive use among HIV-infected women and men receiving antiretroviral therapy in Lusaka, Zambia: a cross-sectional survey</article-title></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Hancock</surname><given-names>Nancy L.</given-names></name><address><phone>+19199665281</phone><fax>+19199666049</fax><email>NancyLHancock@gmail.com</email></address><xref ref-type="aff" rid="Aff1"></xref><xref ref-type="aff" rid="Aff2"></xref></contrib><contrib contrib-type="author"><name><surname>Chibwesha</surname><given-names>Carla J.</given-names></name><xref ref-type="aff" rid="Aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Bosomprah</surname><given-names>Samuel</given-names></name><xref ref-type="aff" rid="Aff2"></xref></contrib><contrib contrib-type="author"><name><surname>Newman</surname><given-names>Jonathan</given-names></name><xref ref-type="aff" rid="Aff2"></xref></contrib><contrib contrib-type="author"><name><surname>Mubiana-Mbewe</surname><given-names>Mwangelwa</given-names></name><xref ref-type="aff" rid="Aff2"></xref></contrib><contrib contrib-type="author"><name><surname>Sitali</surname><given-names>Elizabeth Siyama</given-names></name><xref ref-type="aff" rid="Aff2"></xref></contrib><contrib contrib-type="author"><name><surname>Bolton-Moore</surname><given-names>Carolyn</given-names></name><xref ref-type="aff" rid="Aff1"></xref><xref ref-type="aff" rid="Aff2"></xref></contrib><contrib contrib-type="author"><name><surname>Mbwili-Muleya</surname><given-names>Clara</given-names></name><xref ref-type="aff" rid="Aff3"></xref></contrib><contrib contrib-type="author"><name><surname>Chi</surname><given-names>Benjamin H.</given-names></name><xref ref-type="aff" rid="Aff1"></xref><xref ref-type="aff" rid="Aff2"></xref></contrib><aff id="Aff1"><label></label>Department of Obstetrics and Gynecology, UNC Global Women’s Health, University of North Carolina School of Medicine, 3009 Old Clinic Building, Campus, Box 7577, Chapel Hill, NC 27599-7577 USA</aff><aff id="Aff2"><label></label>Centre for Infectious Disease Research in Zambia, PO Box 34681, 5032 Great North Road, Lusaka, Zambia</aff><aff id="Aff3"><label></label>Lusaka District Community Health Office, Ministry of Community Development, Mother and Child Health, PO Box 50827, Lusaka, Zambia</aff></contrib-group><pub-date pub-type="epub"><day>12</day><month>5</month><year>2016</year></pub-date><pub-date pub-type="pmc-release"><day>12</day><month>5</month><year>2016</year></pub-date><pub-date pub-type="collection"><year>2016</year></pub-date><volume>16</volume><elocation-id>392</elocation-id><history><date date-type="received"><day>3</day><month>10</month><year>2015</year></date><date date-type="accepted"><day>4</day><month>5</month><year>2016</year></date></history><permissions><copyright-statement>© Hancock et al. 2016</copyright-statement><license license-type="OpenAccess"><license-p><bold>Open Access</bold>This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">http://creativecommons.org/licenses/by/4.0/</ext-link>), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/publicdomain/zero/1.0/">http://creativecommons.org/publicdomain/zero/1.0/</ext-link>) applies to the data made available in this article, unless otherwise stated.</license-p></license></permissions><abstract id="Abs1"><sec><title>Background</title><p>Family planning (FP) is an essential health service and an important part of comprehensive HIV care. However, there is limited information about the contraceptive needs of people living with HIV in sub-Saharan Africa, which in turn has hampered efforts to expand and integrate FP services into existing HIV programs.</p></sec><sec><title>Methods</title><p>We performed a cross-sectional survey to determine FP prevalence and predictors among HIV-positive women and men attending 18 public antiretroviral therapy (ART) clinics in Lusaka, Zambia. Trained peer counselors administered the 10-question survey to those seeking care for five days at each of the target sites.</p></sec><sec><title>Results</title><p>From February to April 2014, we surveyed 7,046 HIV-infected patients receiving routine HIV services. Use of modern contraception was reported by 69 % of female ART patients and 79 % of male ART patients. However, highly effective contraceptive use and dual method use were low among women (38 and 25 %, respectively) and men (19 and 14 %, respectively). HIV disclosure status (adjusted odds ratio (AOR) = 4.91, 95 % confidence interval (CI) = 3.32–7.24 for women, AOR = 3.58, 95 % CI = 2.39–5.38 for men) and sexual activity in the last 6 months (AOR = 5.80, 95 % CI = 4.51–7.47 for women, AOR = 6.24, 95 % CI = 3.51–11.08 for men) were associated with modern contraceptive use in multivariable regression. Most respondents said they would access FP services if made available within ART clinic.</p></sec><sec><title>Conclusions</title><p>While FP-ART integration may be a promising strategy for increasing FP service uptake, such services must focus on assessing sexual activity and advocating for dual method use to increase effective contraceptive use and prevent unintended pregnancies.</p></sec></abstract><kwd-group xml:lang="en"><title>Keywords</title><kwd>Family planning</kwd><kwd>Contraception</kwd><kwd>HIV infection</kwd><kwd>HIV positive</kwd><kwd>Africa</kwd><kwd>Zambia</kwd></kwd-group><funding-group><award-group><funding-source><institution-wrap><institution-id institution-id-type="FundRef">http://dx.doi.org/10.13039/100000030</institution-id><institution>Centers for Disease Control and Prevention</institution></institution-wrap></funding-source><award-id>U2G GH000226</award-id></award-group><award-group><funding-source><institution-wrap><institution-id institution-id-type="FundRef">http://dx.doi.org/10.13039/100000002</institution-id><institution>National Institutes of Health</institution></institution-wrap></funding-source><award-id>T32 HD075731, 1R25TW009340-01</award-id><principal-award-recipient><name><surname>Chi</surname><given-names>Benjamin H.</given-names></name></principal-award-recipient></award-group></funding-group><custom-meta-group><custom-meta><meta-name>issue-copyright-statement</meta-name><meta-value>© The Author(s) 2016</meta-value></custom-meta></custom-meta-group></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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