Access to contraception and HIV testing among young women in a peri-urban district of Uganda

Abstract

The purpose of the study was to assess care-seeking practices for contraception and human immune deficiency virus (HIV) testing services among young women (14-24 years) in a peri-urban district of Uganda. A formative study assessed care-seeking practices among women in Wakiso district, Central Uganda. A survey was carried out in 11 randomly selected parish clusters targeting women in the reproductive age group. Data on current use of contraception, information from women who had been tested for HIV, future desire for an HIV test, and choice of care were captured. A total of 10,993 women were interviewed of whom young women were 5384 (49.0%). The proportion of young women using a method of contraception was less, 2446 (45.8%), compared with 2832 (54.3%) for older women, p=0.0001. Few adolescents (14-19 years), 850 (45.3%), had tested for HIV compared with older women, p=0.0001, whereas majority of the young women, 1321 (75.5%), wished to have an HIV test compared with older women, 742 (66.0%), p=0.0001. Fear for an HIV test was common among women of both age groups, p=0.9. Data further show that young women were less likely to deliver at hospitals, 1582 (50.8%), compared with older women, 2586 (53.3%), p=0.0001. Similarly, a lesser proportion of young women, 845 (50.4%), sought contraception at hospitals compared with older women, 1432 (54.4%), p=0.004. The factors that most influenced access to services were age, educational level, source of care, marital status, and future intention to use a particular service. Young women are less likely to access contraception and HIV testing services in this district. These results will be useful in designing and evaluating future interventions targeting young women.