Positive Deviance for Dual-Method Promotion among Women in Uganda: A Qualitative Study
Dual-method use is the most reliable form of protection against unintended pregnancies and human immunodeficiency virus/sexually transmitted infections (HIV/STIs). Although dual-method use remains uncommon among women in stable relationships, some women do practice it. In this study, we explored the...
Main Authors: | , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
MDPI AG
2020-07-01
|
Series: | International Journal of Environmental Research and Public Health |
Subjects: | |
Online Access: | https://www.mdpi.com/1660-4601/17/14/5009 |
id |
doaj-1e227b5228644fcb822c8453a673d8cb |
---|---|
record_format |
Article |
spelling |
doaj-1e227b5228644fcb822c8453a673d8cb2020-11-25T02:14:06ZengMDPI AGInternational Journal of Environmental Research and Public Health1661-78271660-46012020-07-01175009500910.3390/ijerph17145009Positive Deviance for Dual-Method Promotion among Women in Uganda: A Qualitative StudyHodaka Kosugi0Akira Shibanuma1Junko Kiriya2Ken Ing Cherng Ong3Stephen Mucunguzi4Conrad Muzoora5Masamine Jimba6Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033, JapanDepartment of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033, JapanDepartment of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033, JapanDepartment of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033, JapanUNICEF Uganda Country Office, Kampala P.O. Box 7047, UgandaDepartment of Internal Medicine, Mbarara University of Science and Technology, Mbarara P.O. Box 1410, UgandaDepartment of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033, JapanDual-method use is the most reliable form of protection against unintended pregnancies and human immunodeficiency virus/sexually transmitted infections (HIV/STIs). Although dual-method use remains uncommon among women in stable relationships, some women do practice it. In this study, we explored the barriers that make dual-method use rare and the behaviors of women who practice dual-method use using a positive deviance framework in Uganda. We screened 150 women using highly effective contraceptives at five health facilities. We identified nine women who practiced dual-method use and 141 women who did not. In a qualitative study, we conducted in-depth interviews with all nine women practicing dual-method use and 10 women randomly selected out of the 141 who did not. We performed a thematic analysis using the positive deviance framework. Regardless of practicing dual-method use or not, women faced perceived barriers against dual-method use, such as partner’s objection, distrust, shyness about introducing condoms into marital relationships, and limited access to condoms. However, women practicing dual-method use had higher levels of risk perception about unintended pregnancies and HIV/STIs. They also engaged in unique behaviors, such as influencing their partners’ condom use by initiating discussions, educating their partners on sexual risks and condom use, and obtaining condoms by themselves. These findings will be useful in developing effective community-led and peer-based interventions promoting dual-method use to reduce the dual burden of unintended pregnancies and HIV/STIs among women in Uganda.https://www.mdpi.com/1660-4601/17/14/5009positive deviancedual-method usecontraceptionunintended pregnancysexually transmitted infectionHIV/AIDS |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Hodaka Kosugi Akira Shibanuma Junko Kiriya Ken Ing Cherng Ong Stephen Mucunguzi Conrad Muzoora Masamine Jimba |
spellingShingle |
Hodaka Kosugi Akira Shibanuma Junko Kiriya Ken Ing Cherng Ong Stephen Mucunguzi Conrad Muzoora Masamine Jimba Positive Deviance for Dual-Method Promotion among Women in Uganda: A Qualitative Study International Journal of Environmental Research and Public Health positive deviance dual-method use contraception unintended pregnancy sexually transmitted infection HIV/AIDS |
author_facet |
Hodaka Kosugi Akira Shibanuma Junko Kiriya Ken Ing Cherng Ong Stephen Mucunguzi Conrad Muzoora Masamine Jimba |
author_sort |
Hodaka Kosugi |
title |
Positive Deviance for Dual-Method Promotion among Women in Uganda: A Qualitative Study |
title_short |
Positive Deviance for Dual-Method Promotion among Women in Uganda: A Qualitative Study |
title_full |
Positive Deviance for Dual-Method Promotion among Women in Uganda: A Qualitative Study |
title_fullStr |
Positive Deviance for Dual-Method Promotion among Women in Uganda: A Qualitative Study |
title_full_unstemmed |
Positive Deviance for Dual-Method Promotion among Women in Uganda: A Qualitative Study |
title_sort |
positive deviance for dual-method promotion among women in uganda: a qualitative study |
publisher |
MDPI AG |
series |
International Journal of Environmental Research and Public Health |
issn |
1661-7827 1660-4601 |
publishDate |
2020-07-01 |
description |
Dual-method use is the most reliable form of protection against unintended pregnancies and human immunodeficiency virus/sexually transmitted infections (HIV/STIs). Although dual-method use remains uncommon among women in stable relationships, some women do practice it. In this study, we explored the barriers that make dual-method use rare and the behaviors of women who practice dual-method use using a positive deviance framework in Uganda. We screened 150 women using highly effective contraceptives at five health facilities. We identified nine women who practiced dual-method use and 141 women who did not. In a qualitative study, we conducted in-depth interviews with all nine women practicing dual-method use and 10 women randomly selected out of the 141 who did not. We performed a thematic analysis using the positive deviance framework. Regardless of practicing dual-method use or not, women faced perceived barriers against dual-method use, such as partner’s objection, distrust, shyness about introducing condoms into marital relationships, and limited access to condoms. However, women practicing dual-method use had higher levels of risk perception about unintended pregnancies and HIV/STIs. They also engaged in unique behaviors, such as influencing their partners’ condom use by initiating discussions, educating their partners on sexual risks and condom use, and obtaining condoms by themselves. These findings will be useful in developing effective community-led and peer-based interventions promoting dual-method use to reduce the dual burden of unintended pregnancies and HIV/STIs among women in Uganda. |
topic |
positive deviance dual-method use contraception unintended pregnancy sexually transmitted infection HIV/AIDS |
url |
https://www.mdpi.com/1660-4601/17/14/5009 |
work_keys_str_mv |
AT hodakakosugi positivedeviancefordualmethodpromotionamongwomeninugandaaqualitativestudy AT akirashibanuma positivedeviancefordualmethodpromotionamongwomeninugandaaqualitativestudy AT junkokiriya positivedeviancefordualmethodpromotionamongwomeninugandaaqualitativestudy AT keningcherngong positivedeviancefordualmethodpromotionamongwomeninugandaaqualitativestudy AT stephenmucunguzi positivedeviancefordualmethodpromotionamongwomeninugandaaqualitativestudy AT conradmuzoora positivedeviancefordualmethodpromotionamongwomeninugandaaqualitativestudy AT masaminejimba positivedeviancefordualmethodpromotionamongwomeninugandaaqualitativestudy |
_version_ |
1724901945607454720 |