Prevalence and determinants of non-barrier contraceptive use in HIV-positive women who attend HIV services at public sector clinics in Gugulethu

• Main Author: Maksimoski, Nancy
• Other Authors: Cooper, Di
• Format: Dissertation
• Language: English
• Published: University of Cape Town 2014
• Subjects: Epidemiology and Biostatistics
• Online Access: http://hdl.handle.net/11427/9412

Includes bibliographical references. === [Background] South Africa has one of the highest prevalences of HIV-infection in women of reproductive age and a high rate of unplanned pregnancy. It is important to explore contraceptive use in HIV-positive women to better understand how to facilitate service delivery to those women wishing to avoid pregnancy. While it is critical to emphasise condom use, information is needed on the factors that contribute to nonbarrier contraceptive use (NBCU) and its prevalence among HIV-positive women in order to afford women the opportunity to choose to have maximum dual method protection to prevent both infection and unwanted pregnancy. While there is literature on people living with AIDS and contraceptive use from other areas of the world, there is little quantitative research conducted in a South African context, although there is evidence of a high proportion of unwanted pregnancy among HIVpositive women in this setting. [ Rationale and Justification for Research ] Information is needed to understand the factors that contribute to NBCU by HIVpositive women, including the prevalence of these determinants. By better understanding the obstacles to non-barrier contraceptive use, both HIV and reproductive health services will better be able to provide more appropriate contraceptive health care to HIV-positive women. [ Aims ] The aim of this study is to determine the prevalence of NBCU and the types of methods used innon-pregnant, HIV-positive women, and to determine the factors that influence the choice of NBCU. [ Objectives ] To determine the prevalence of NBCU in a population of HIV-positive South African females; To determine what factors influence NBCU in women infected with HIV, including whether or not NBCU changes after an HIV-positive diagnosis; To compare the NBCU prevalence among HIV-positive women who want children in the future to 8 those who do not want children in the future, and who are currently on antiretroviral therapy (ART) to those who are not currently on ART; To determine what factors influence NBCU for particular subsets of women, including those with and without fertility intentions in the next 12 months and women currently on and not on ART; To determine the unmet need for non-barrier contraception in HIV-positive women. [ Methods ] This study will form a part of a larger cross-sectional study, which collected data on the fertility intentions and the utilization of HIV and reproductive health services of 459 HIV-seropositive men and women from the peri-urban informal settlement of Gugulethu, located outside of Cape Town, from May to September 2006. Data was collected by trained fieldworkers through the use of a standardised quantitative survey instrument. A qualitative study consisting of in-depth interviews and focus groups with HIV-infected men was also conducted as part of the larger research project. After being cleaned, data was transferred to STATA Release 10 (STATACorp, College Station, USA) where bi-variate and multi-variate statistical analysis was performed. [ Ethics ] The Ethical Review Committee of the World Health Organisation and the Research Ethics Committee of the University of Cape Town, the research partners in this study, granted ethical approval to the larger cross-sectional study to which this sub-study is part. All participants who agreed to the voluntary interview provided informed consent, and although the risk of personal harm was very low, effort was put forth to minimise non-maleficence.